Kentucky Medicare Supplement
If you are a Kentucky resident and a beneficiary of Original Medicare, you might be wondering what you can do to further reduce how much you spend on hospital and general medical bills. The purpose of Medicare Part A and Part B is to help cover a part of such expenses, but it cannot shoulder everything. This is the reason why the federal government introduced and standardized Medicare Supplements (also called Medigap), in order to take care of the “gaps” that Original Medicare is not able to pay for.
How do Medicare and Medigap complement each other? Let’s say you got hospitalized. Medicare will pay for its share of your bill, according to a predetermined amount, and then Medigap will take care of the remainder (depending on its benefits offered). There will be certain instances where the patient will end up with zero billing when both come into play, while others will definitely see a significant drop in their out-of-pocket costs. For senior citizens, who will have retired by the age of 65 and have no regular source of income, this is already a godsend.
Senior Citizen Numbers in Kentucky
As of 2019, Kentucky has an estimated total population of 4.48 million, according to the World Population Review. Of this number, around 673,000 are senior citizens. Meanwhile, America’s Health Rankings state that the number of home health care workers that focus on seniors rose 11% from 2017 to 62.6 workers per 1,000 adults aged 75 years and older. As the increase in senior numbers continue, with no sign of slowing down, the government is looking for more ways to provide its citizens the care they need in their twilight years.
While seniors with a dedicated health care provider at home are better off in terms of preventing, detecting and managing health issues, not everybody in Kentucky has access to such levels of monitoring and care. This is because of financial constraints, limited access, and a lack of knowledge about their entitlements and benefits and of available providers and services.
What Medigap Covers
There are 10 Medigap policies available, all of which are standardized by the federal government. Though these are sold through private insurance agencies, the state still regulates their distribution in order to ensure that all seniors around the United States have the same level of access to important healthcare services. Insurers cannot alter the benefits included in a specific plan, nor can they change the amount of coverage is assigned to each one. What they can do, however, is set their own pricing for monthly premiums.
Medicare covers a mix of benefits, as follows:
– Part A Medicare coinsurance or copayment
– Part B Medicare coinsurance of copayment
– Blood (only the first three pints)
– Skilled nursing facility care coinsurance
– Part A deductible
– Part A coinsurance or copayment for hospice care
– Part B deductible
– Part B excess charges
– Foreign travel emergency expenses (up to plan limits)
What they DO NOT cover are dental and vision care, eyeglasses, hearings aids, long-term care (as with a nursing home), and private-duty nursing. If you need coverage for these, you will have to apply for another type of insurance product, depending on what your preferred private agency sells.
Understanding Part B Excess Charges
Part B excess charges refer to the amount that a doctor can add to your final bill, up to a maximum of 15%. This applies if the doctor does NOT accept Medicare assignment. Take note that a physician may accept Medicare but not Medicare assignment, so it is important to ask specific questions before you avail his or her service. Typically, Part B excess charges are implemented by specialists.
For example, if you are undergoing a procedure that costs $400 dollars and Medicare has approved shouldering that $400, then you pay nothing. However, if your doctor does not accept assignment, he or she can add 15% to this amount, making the final bill $460. Your Medigap plan can then shoulder the remaining $60 so you get zero billing in the end. Note that only Medigap Plan F and Plan G cover Part B excess charges (100%).
It is important to note that there are changes coming to Part B excess charges come January 1, 2020. By the said date, plans that include such benefit will no longer be sold to new enrollees. If you become eligible for Medicare AFTER January 1, then neither will be offered to you. However, if you qualified for insurance before the mentioned date, then you can still apply for it. In addition, if you already have a Plan F or Plan G policy, then you may continue to use your old plan without any changes (and charges).
Best Time to Apply for a Medigap Plan
The best time to purchase a Medicare Supplement plan is during your OEP or Open Enrollment Period. This begins on the first day of the month that you turn 65 years old and ends six months after. If your 65th birthday is on June 15, then your OEP starts in June 1. During this time, you can apply for ANY Medigap plan you want and will have guaranteed approval. You will also not be subjected to any medical underwriting. It should be emphasized that you buy your policy according to schedule to avoid any inconveniences. For one, if you miss your OEP, you might be denied the policy or be charged higher after undergoing a health assessment.
Average Cost of Medicare Supplements in Kentucky
As mentioned earlier, insurance providers can set their own pricing for Medigap plans, even if they are exactly the same policy. This is why you should shop around Kentucky first and compare costs and services before you sign up for any plan. As of 2018, the average monthly premiums for Medicare Supplements in the state is $139.16 ($1,670 per year). The lowest average is recorded in Hawaii ($109.16 per month) while the highest is recorded in Massachusetts ($162.25 per month).
Have More Questions About Kentucky Medicare Supplements?
Interested in finding out more about Medigap plans and providers in Kentucky? Our team of licensed advisers will be happy to assist with any queries. If you’re still undecided over which type of policy to purchase, we can help lay out your options so that you can make an informed decision before settling on a plan. Contact us at 1-800-791-0150.
