Last updated on: November 08, 2022
Figuring out what kind of healthcare coverage you need can be confusing. Here’s everything you need to know about Medicare Supplement, or Medigap, insurance in Maryland!
What is Maryland Medicare Supplement, and Why Do You Need It?
Original Medicare (Parts A and B) is the health insurance program offered by the federal government. Millions of elderly Maryland residents rely on Medicare for medical coverage, but Parts A and B are not free, and the coverage they offer is far from comprehensive. Original Medicare only pays for 80% of approved healthcare costs. The other 20% will be left up to you. While 20% may not seem like a lot, for surgeries, treatments, hospital stays, deductibles, copays, and more, 20% can be a financially devastating amount to most average senior retirees. For example, 20% of a $45,000 knee replacement surgery is $9,000, and that does not include the cost of a hospital stay, rehabilitation, copays, follow-up visits, and pain medications. The majority of Medicare beneficiaries in Maryland don’t have $9,000 just lying around, particularly if they are no longer receiving income other than Social Security. There is no cap on the amount that you can spend each year; if you have a year marked by poor health, then you could potentially pay tens of thousands of dollars out of pocket.
That’s where Medicare Supplement insurance comes in. Medicare Supplement Plans, also commonly referred to as Medigap Plans in Maryland, are designed to fill in these expensive gaps in Original Medicare. These plans, sold by private insurance companies, pay for the remaining cost of copays, coinsurance, deductibles, and other things that Medicare does not fully cover. Medigap Plans also pay for some additional services that Medicare does not fully cover at all. This type of insurance does not replace your Original Medicare, but supplements it instead. When you have a Medicare Supplement Plan, and incur a healthcare cost, your Original Medicare will pay its share first, and then your Medicare Supplement Plan will cover the rest.
Having a Medicare Supplement Plan can help you save significantly on healthcare costs and give you the peace of mind that no matter what health situations you may face, you are protected financially.
Who Can Purchase a Medicare Supplement Plan in Maryland?
In Maryland, in order to be eligible for a Medicare Supplement Plan, you have to already be enrolled in Original Medicare Parts A and B. This means you must be a U.S. citizen or a permanent legal resident for at least five continuous years. You need to be 65 or older, or diagnosed with end stage renal disease (kidney failure), or receiving disability benefits, or diagnosed with ALS (Lou Gehrig’s disease). If you have worked ten years or more and paid Medicare taxes, and meet the stated requirements, you are automatically enrolled in Part A and B (Part A is premium-free; for Part B you pay a monthly premium).
In some states, you may be able to purchase a Medicare Supplement Plan if you are under 65, but the premium may be higher, and the insurer may be able to evaluate you medically and screen you for certain conditions, which could affect your coverage.
Medicare Supplement vs Medicare Advantage in Maryland
Medicare Supplement Plans and Medicare Advantage Plans are two ways of getting the essential coverage that Original Medicare does not offer. Medicare Supplement, or Medigap, Plans supplement the gaps left by Original Medicare, while Medicare Advantage Plans (Part C) replaces the benefits of Original Medicare. Part C Plans are alternative ways of recieving these benefits. These plans are much like private health insurance, covering most services after copays, and must provide at least the same level of coverage that Original Medicare does. These plans may also include additional benefits. However, about 80% of Americans choose a Medicare Supplement Plan, as it gives you the freedom to see any doctor or provider, anywhere in the U.S., without a referral, that accepts Medicare (most do).
Medicare Supplement Plans and Medicare Advantage Plans cannot work together. It is illegal for any insurer to sell you a Medigap Plan if you currently have a Medicare Advantage Plan unless you are switching back to Original Medicare.
The Plan Types Explained & Which are Available in Maryland
There are eight types of Medicare Supplement Plans available: A, B, D, G, K, L, M, and N (as of 2020; Plan F and Plan C are being phased out and can no longer be sold to new enrollees). In 2010, these plans were standardized by the federal government in all but three states (Massachussetts, Minnesota, Winsconsin), meaning that a plan type with the same letter will offer the exact same benefits, anywhere you are. The only difference is the price. For example, let’s say one insurer is selling Medigap Plan G for $100. Another insurer in another state is selling Medigap Plan G for $130. Both Plan Gs are identical and will offer you the same coverage; the only difference is the price. Think of it like buying gas. Any gas station you go to basically sells the same product, but at different prices.
Some plan types offer more coverage than others, which is a factor that affects how much you can expect to pay. Plan G is the most comprehensive of the eight plan types and therefore will be more expensive than Plan A (the least comprehensive), for example. Insurance companies do not have to sell all of these plan types, but if they sell any Medigap Plan, they have to offer to sell Plan A.
Important Facts You Should Know About Maryland Medicare Supplement
- All Maryland Medigap Plans are guaranteed renewable for life. This means that as long as you pay your premiums on time, you cannot be denied coverage due to your health or age, even if you develop a serious condition while on the plan.
- In Maryland, Medicare Supplement Plans do not cover vision, dental, hearing, or private-duty nursing insurance, so you may need to purchase additional health insurance for those needs.
- If you have Medigap policy, you will continue to pay your Part B premium in addition to the Medigap policy premium.
- Medicare Supplement Plans only cover individuals, not spouses or families; each individual must purchase their own plan if they want coverage.
- There could be penalties for dropping your Medicare Supplement Plan if you enroll late in your new plan.
Best Time To Buy Medicare Supplement
Ideally, you should buy Medicare Supplement coverage during Maryland's Medigap Open Enrollment Period. This period lasts for six months and begins on the first day of the month when you are 65 and older and enrolled in Part B Medicare.
If you do not enroll during this period, insurers can deny you coverage or raise prices based on your health status, but if you enroll within your OEP then you are protected, and your plan is guaranteed renewable for life.
How To Choose The Right Maryland Medicare Supplement Plan
Selecting the best Medicare Supplement Plan for your health needs and budget can be overwhelming with all of the options available to you. That’s why it’s best to work with an experienced agent who can help you find a policy with the perfect amount of coverage! Put in your zip code so we can give you a free Maryland Medicacare Supplement quote and help you get the coverage you need.
Categories: Medicare Articles, Medigap Eligibility, Medigap Coverage