Navigation: Home > Learning Center > Medigap Coverage
print icon printer-friendly email icon contact us

Medigap Coverage*

What is Medicare?

Medicare is a federal health insurance program for people age 65 or older, under age 65 with certain disabilities, and any age with permanent kidney failure (called End-Stage Renal Disease or ESRD).


Who Qualifies for Medicare?

In order to qualify for Medicare you must be a United States citizen or permanent resident age 65 or older and receive or are eligible to receive Social Security benefits. Or, you receive or are eligible to receive railroad retirement benefits; or you or your spouse (living or deceased, including divorced spouses) worked long enough in government employment where Medicare taxes were paid; or you are the dependent parent of someone who worked long enough in government employment where Medicare taxes were paid. Also, certain people younger than age 65 can qualify for Medicare, including those who have disabilities and those who have permanent kidney failure or amyotrophic lateral sclerosis (Lou Gehrig's disease).


What is Medicare Part A?

Medicare Part A can be categorized as hospitalization insurance. It covers inpatient care in hospitals, skilled nursing facilities and qualified home health and hospice care.


What is Medicare Part B?

Medicare Part B can be categorized as medical insurance. It covers doctor's services and outpatient care, and certain other Medicare services that Part A does not cover (like physical and occupational therapists) and some home health care.


What is Medicare Part C?

Medicare Part C, formerly known as "Medicare+Choice," is now known as "Medicare Advantage". Private insurers manage Medicare Advantage plans, like HMOs and PPOs. In order to join a Medicare Advantage Plan, you must qualify for Medicare Part A and Part B before you can apply for Part C.


What is Medicare Part D?

Medicare Part D is prescription drug coverage, also offered through private insurers, and covers only Medicare approved prescription drugs.


When can I apply for Medicare Part B?

You may apply for Medicare Part B when you turn age 65. If you still have group coverage through an employer, you do not have to sign up for Part B until that coverage ends. Individuals have the 3 months prior to turning 65 and 3 months following to apply.

 

After the year you turn 65, a 10% increase in premium penalty applies for each year of delay applying for Part B benefits.

 

MEDICARE SUPPLEMENT


What is a Medicare Supplement?

Medicare Supplement insurance is a supplemental insurance product designed to help pay for medical expenses not covered by Medicare. Medicare Supplement insurance plans are standardized by most states so that all insurance companies will have the same basic benefits for each category of plans.


How old do I have to be to purchase Medicare Supplement?

Like Medicare insurance, you must be age 65 or older to purchase a Medicare Supplement plan, and persons with disabilities who qualify for Medicare may also purchase Medicare Supplement insurance.


Are there different types of Medicare Supplement plans?

Yes, there are twelve standardized plans - A through L - and each plan comes with different rates and benefits.


Are there advantages to selecting a Medicare Supplement plan versus a Medicare Advantage plan?

While the answer to this question may reflect your particular preferences, there are certain key features to a Medicare Supplement that should be considered. For example, because Medicare Supplement plans are open plans, you can visit the physician of your choice and are not limited to a particular network. Also, with a Medicare Supplement, you have the freedom to travel the country and receive the same benefits from state to state. For more information and Medicare Supplement plans, see your insurance professional.


When can I qualify for Open Enrollment for a Medicare Supplement policy?

Once you have received both Medicare Part A and Part B you have a 6 month qualification period following your enrollment in Medicare Part B.


What is "guaranteed issue"?

"Guaranteed Issue" is when you are not required to provide evidence of insurability to obtain coverage. If your health coverage terminates under certain circumstances you may be able to enroll in a Medicare Supplement policy regardless of your health status.


What is an example of someone who would qualify for guaranteed issue for Medicare Supplement?

Someone whose group coverage is ending would qualify as guaranteed issue for Medicare Supplement.


How long is the qualification period for guaranteed issue?

You must enroll within 63 days after your health insurance ends.

 

Neither Standard Life and Accident Insurance Company nor its representatives gives legal, tax or accounting advice. If you need such advice, consult your attorney, accountant or personal tax advisor.

 

Standard Life and Accident does not offer to sell, nor solicit an offer to buy any insurance product in any jurisdiction in which the Company is not authorized to do business or the product is not approved.

 

This page not approved for use in Nevada.





*The term Medigap means a Medicare Supplement policy.