About Medicare Supplemental Insurance
Q. What is a Medicare Supplemental Insurance (Medigap Plan)?
A. Medicare Supplement Insurance, also known as "Medigap" insurance, provides supplemental health insurance coverage for Medicare beneficiaries. This type of insurance will fill in the “holes and gaps” that the Medicare program does not cover. Individuals in the “original” Medicare program may want to obtain Medicare Supplement (“Medigap”) insurance because Medicare often covers less than the total cost of the beneficiary's health care. In North Carolina there are eleven (11) different Medicare Supplemental Plans to choose from, each offering different benefits.
Q. Why do I need a Medicare Supplemental Plan (Medigap Plan)?
A. A Medicare Supplemental Plan offers coverage for health care services that are not covered by Medicare Part A and Medicare Part B. Certain Medicare Supplemental Plans will pay for your Inpatient Hospital Deductible each benefit period and/or your Part B deductible. Some additional services covered by Medicare Supplemental Plans are:
1. Hospital co-payments
2. First three (3) pints of blood per calendar year
3. Nursing Home co-payments
4. Generally, 20% of Medicare approved amount of Part B physician and
medical services after Part B deductible is met
5. Hospice care
6. 100% of Medicare Part B excess charges
Q. Where can I enroll in a Medicare Supplemental Plan?
A. You can enroll in a North Carolina Medicare Supplemental Plan by clicking here. Or you may call us at 1-800-323-6525 ext. 29, and we will send you an application via the mail.
Q. How much does a Medicare Supplemental Plan cost?
A. Medicare Supplemental Insurance costs vary according to the Plan you choose and the company you use. The Premium rates vary widely from company to company for the same policy benefits.
Q. What is the difference between a Medicare Supplemental Plan and a Medicare Advantage Plan?
A. A Medicare Advantage Private-Fee-for-Service Plan is a health plan offered by private insurance companies under contract with the Medicare program. It requires your health care provider to participate in the Medicare Advantage plan you have chosen or your claims will NOT be covered. Some Medicare Advantage plans have an “out of pocket cost” of $5,000 or more per year. Medicare Advantage plans may cost less than a Medicare Supplemental plan, but they do not offer the same benefits. Finally, the North Carolina Department of Insurance has no regulatory authority over Medicare Managed Care plans.