Last year, my neighbor Jim retired from his job as a property manager. Jim felt that since he was in excellent health, Medicare Part A and Medicare Part B was sufficient coverage for his needs. During the initial enrollment period (when you turn 65 and are enrolled in Medicare Part B), a Medicare supplement is guarantee issued to you. You do not have to meet the medical underwriting requirements.
Four months after Jim turned 68, he began experiencing episodes of shortness of breath while he took morning walks with his wife. He developed some serious heart and lung problems, and decided to apply for a Medicare supplement to cover the expensive out of pocket costs he was now responsible for, that original Medicare (Medicare Part A and Medicare Part B) do not cover. He obtained an application for a medicare supplement and noticed that there are health questions that need to be answered in order to qualify for a supplement. Jim had three of the conditions listed on the application and realized that he did not meet the criteria for a supplement.
The result was that Jim enrolled in a Medicare Advantage Plan. He was glad to be accepted, but was not glad about the limitations to one particular network. Jim would have preferred to have the freedom to go to any doctor or hospital, and not have to be concerned about co-pays, deductibles and staying within one network of providers. Jim’s advice to anyone in excellent health at age 65 is “apply for health insurance when you are at your optimal level of health. Then you will be accepted into any plan and not worry about being declined because of a certain medical condition(s)”.
Many Medicare recipients will need supplemental health insurance to fill in the gaps of what Medicare does not cover. A Medicare Supplement Insurance policy (also called a Medigap) is private health insurance designed to supplement Original Medicare. This means that it helps pay some of the health care costs (“gaps”) that Original Medicare doesn’t cover (like coinsurance, co-payments, deductibles, and prescription drugs). There are several different types of Medicare Supplements you can purchase and I am glad to explain all of your options to you. Please beware that neither Medicare nor a Medicare Supplement will cover the expenses of long term care. Long term care is a separate type of insurance policy.
