For those entering Medicare, it may still be a surprise to find out that "all" of their medical expenses are not covered. Medicare is not the same as the insurance you are probably used to during your working years. For example, one senior we'll call her "Danielle" recently found out that her Original Medicare plan did not cover a portion of her hospital stay. Even though she had faithfully paid her premiums, she was left with a large sized bill that she will have to pay out of pocket.

Original Medicare Only Covers So Much

This is a common issue for Medicare beneficiaries who only get Medicare Parts A and B. Original Medicare has no "Out of Pocket Maximum" and only covers certain medical expenses, such as hospital stays and physician visits, but there are gaps in coverage for other treatments and services. That is why many seniors will opt for a Medicare supplemental plan, especially one that is an issue age policy.

There Are Gaps in Coverage

Medicare is the federal health insurance program for people over 65 and those with disabilities. While Medicare provides a great amount of coverage, there are still gaps. With Original Medicare (Parts A and B), you will be responsible for more than copayments, coinsurance, and deductibles. Additionally Medicare does not typically cover long-term care or vision and dental services either. For those nearing their retirement days, it is not an easy task to manage the cost of health care when you’re living on a fixed income.

Medicare Supplemental Plans

Retirement is here! Enjoy more of your time in life, what you don't want is to worry about losing money over medical bills. Your initial approach to prioritizing and managing your healthcare portfolio will affect this particular scenario for the rest of your life. What you want to understand is what you put in is what you get out,

Before signing up for a supplemental plan, it's important to understand what type of coverage is being offered and how much it will cost. It's also important to consider if you will need additional coverage in the future, such as if you plan to travel frequently or if you expect your medical needs to change over time.

How to Choose a Supplemental Plan

When it comes to choosing a Medicare Supplemental plan, it’s important to know what your needs are and what type of health insurance coverage is right for you. Supplemental plans fill in the gaps that Original Medicare does not cover and can provide additional benefits such as vision, hearing, and dental coverage. The most popular supplemental plans are Medigap Plans not to be confused with a Medicare Advantage.

When choosing a supplemental plan, you should consider your health care needs and budget. Evaluate your current medical expenses and make sure to choose a plan that covers your needs without exceeding your budget. You should also research the different options available to you and compare the benefits and costs of each plan to ensure you’re getting the best deal. Finally, make sure to read the fine print so you understand exactly what you’re signing up for.

Does Everyone Need a Supplemental Plan?

When it comes to  your healthcare, what you want to consider is, "Who is going to pay?" or "Do I want to pay for ________ when it happens?"  Insert your scenario or bill now and as your health naturally declines in the future.

The truth is not everyone can have one. If you have a Medicare C you cannot have a Medicare Supplement Plan to cover your gaps.  Also, depending on your individual health needs and lifestyle, you may be tempted to believe that you get by with just Original Medicare. 

Although you have that option, you may want to take a closer look. People who may be tempted to pass on additional coverage include those who:

• Have no health problems or any foreseeable health issues
• Don’t currently take many prescription drugs
• Don’t anticipate any medical visits or hospital stays right now
• Can afford to pay out of pocket for their health care expenses out right

If you fall into this category, you may not 'need' the additional coverage that comes with a Medicare Supplemental plan. Keep in mind, however, that even if you think you don’t need a supplemental plan, it’s always a good idea to have some form of plan in place with your health insurance. Without it, statistically and naturally, you may find yourself facing unexpectedly high medical bills in the event of an accident or serious illness.

How Much Does a Supplemental Plan Cost?

When it comes to health insurance, the cost of a Medicare Supplemental plan varies greatly and will depend on what you need want, which carrier you trust, and again what you want to contribute along the way. Why so many plans? Because there are so many scenarios, but only one you.

The most beautiful sight to see and that you can hear after a preventative visit, a pricey test, or after an expensive procedure..."You pay $0."

In addition to supplemental health insurance, there are also other health insurance options available for those who don't qualify for Medicare or who want additional protection. Additionally, people who are over 65 may qualify for Medicaid which covers all or part of their medical expenses. No matter what health insurance option you choose, it's important to research different plans to find one that best meets your needs and budget. 

Having adequate health insurance will give you peace of mind knowing that your health care costs are covered when something unexpected does happen. Solidify this correctly and you can continue to use your money where you really want to.

What to Do If You Can't Afford a Supplemental Plan

If you believe you can't afford a Medicare supplemental plan, there are still ways to get the coverage you need...

You may  want to look into high deductible Medicare Supplemental Plan, these offer lower monthly premiums with a deductible before the insurance kicks in if you need care. These plans can be great if you're healthy and don't expect to use your health insurance too often. 

Additionally, you could consider a disappearing deductible plan, which provides a deductible for a few years and disappears giving you both less in premiums and no deductible in the long run. This protection comes in very, very handy when you end up needing more health care than expected during the course of retirement no matter your financial situation. With this type of plan, your deductible is reduced to zero whether you incur more medical expenses or not.

Another option is to purchase a Medicare Advantage plan, which is private health insurance offered through Medicare-approved insurers. These plans will provide more coverage than sticking with just you Part A + B Original Medicare and may also include additional certain options such as vision, dental, or hearing services. Be sure to compare plans and understand what you are giving away  carefully before making a decision.

One option for those with lower resources is applying for Medicaid, a health insurance program funded by the federal and state governments for people with low incomes. Medicaid can help pay for the medical expenses that Original Medicare does not cover. It's important to note, however, that Medicaid eligibility varies from state to state.

No matter what your financial situation is, it's important to explore all of your options when it comes to getting the coverage you need. With careful research and planning, you can find a solution that works for you.  Be sure to look into all of these options to find the best coverage for your needs. Depending on where you live, you might even qualify for health insurance discounts. 

Additionally, health savings accounts (HSAs) can be used to cover medical costs tax-free, giving you another way to keep health care costs down. Researching health insurance providers and comparing different policies online is a great way to start shopping around for an affordable plan. 

What's next?

Make sure you understand how much you’ll be paying each month and any other costs associated with the different coverage types. Utilize a insurance or Medicare Specialist to narrow down policies and carriers utilizing your personal details from your working life, and what you need and want from your retirement life. It's mch more than things like deductibles and co-pays. Knowing all of this information will help ensure you’re getting the most comprehensive health insurance policy possible.  

Once you’ve discussed and narrowed down what you do not want or what you are looking to avoid, talk to an agent who directly can answer questions about policies to make sure what you are planning is the actual and a right fit for you.

There are many different health insurance plans and carriers available, so taking your time, starting early, and reading through the details before committing to one will go a long way!