Oklahoma Medicare Supplement
Having Medicare and Medigap coverage is all the more important these days due to increasing cost of medical expenses and healthcare in general. This is all the more true for those who are turning or have turned 65 years old. Being in the age of retirement most likely means people no longer have regular sources of income the way they did when they were still part of the workforce. In this life stage, individuals rely on their retirement savings, if any, residual income from previous investments, or help from family members.
However, since many seniors are also without families and with minimal savings, the next recourse is to turn to the government for assistance. Medicare was, thus, created to help the elderly cope with the cost of taking care of themselves. However, the federal budget can only go so much, and this is why Medicare Supplements (or Medigap) were introduced. In sum, in the discussion over what seniors truly need in their advancing age, Medicare and Medigap both appear to be necessary.
Benefits of Medicare Supplements
Medigap policies are provided through private insurance agencies and are responsible for shouldering a part of the healthcare expenses that Original Medicare is not able to pay for. Their level of coverage will depend on the type of plan you purchase among the 10 available, ranging from A to N. Some policies have lower cost monthly premiums but have limited coverage, while those with more comprehensive benefits cost higher.
The decision on which type of policy you should apply for depends on your past and current health status and future health projection, as well as your budget. Thus, you must carefully study each plan that’s available in your state so you can maximize your benefits without going beyond your financial capacity. Note that premiums for a Medigap plan are paid on top of what you are already paying for your Medicare Part B.
The basic benefits of Medicare Supplement plans are as follows:
– Medicare Part A hospital costs and coinsurance (up to an extra 365 days after Medicare benefits are exhausted)
– Medicare Part A copayment or coinsurance
– First 3 pints of blood
– Skilled nursing facility care coinsurance
– Part A coinsurance or copayment for hospice care
– Part A and Part B deductibles
– Part B excess charges
– Foreign travel emergency expenses (determined by plan limits, up to 80%)
Requirements and When to Apply for a Medigap Plan
In order to quality for any Medigap plan, you have to fulfill two conditions: 1) You must be enrolled in both Medicare Part A and Part B, and 2) You must be 65 years old.
The most ideal time to apply is when you are first eligible and this is during your Open Enrollment Period. The OEP is a six-month grace period during which time you can apply for and get guaranteed approval for any Medigap plan you want, without being subjected to any health assessment by any insurance provider. It begins on the first day of the month that you become 65 years old. For example, if your birthday is March 5, then your OEP starts March 1.
It is highly recommended that you follow your OEP to avoid any trouble with your application down the line. If you miss this period, not only will you run the risk of having to pay higher premiums after a medical underwriting assessment, you can also be turned down altogether. If you apply within the OEP period, it doesn’t matter what your past or current health condition is. The federal government requires all insurance companies to approve applications. Beyond this time, however, the decision is given back to the private agency.
Senior Citizen Statistics in Oklahoma
According to the U.S. Census Bureau, some 14% of Oklahoma’s population is composed of senior citizens and 28% of this demographic are living on their own. Some are staying in group quarters, other with family, and others are with non-relatives. The median household income for people in this stage is $33,750 based on the numbers of around 85,000 seniors who are still part of the workforce.
While there are plenty of assisted living and skilled nursing facilities, as well as adult day care centers and home health care services, in the state, the fact that many are without a clear source of income to support healthcare expenses in their old age means that there is an untapped demand for Medicare and Medicare Supplement policies. As of 2018, the average cost of Medigap monthly premiums in Oklahoma is $142.66, or $1,712 per year. For comparison purposes, the highest average is recorded in Massachusetts at $162.25 per month, while the lowest average is in Hawaii at $109.16 per month.
How Oklahoma Medigap Plans Are Priced
Your decision on which type of Medigap plan to buy and from which company should also be anchored on how the provider prices its products. In terms of Medicare Supplements, there are generally three types of pricing schemes: Attained-age-rated, Community-rated, and Issue-age-rated.
Attained-age-rated products are priced based on your current age and means that your monthly premium can increase as you get older. Community-rated plans are priced according to the standard rate for everyone with the policy, regardless of gender of age. Issue-rage-rate (also called entry-age-rated) products are based on the age you are when your Medigap plan is purchased and will not change as you grow older. Note that factors like inflation and other economic forces may affect Medigap pricing in the future, which is a separate issue from age.
It is important that you understand how your provider sets its premium prices, so that you don’t experience any surprise increases in the future. The rates when you first signed up might be cheaper than the others, but they could also increase regularly as you age. Thus, be extra mindful and ask questions about pricing systems.
Important Date to Remember with Medigap Moving Forward
As the needs of American seniors change, the guidelines surrounding Medicare Supplements also evolve. Case in point, starting January 1, 2020, Medigap plans sold to new members will not longer carry the Part B deductible. This means that Plan C and Plan F will no longer be sold to new enrollees after the said date. However, if you already have one, then you many continue enjoying the old plan’s benefits.
Oklahoma Resident? We Can Help
Are you resident of Oklahoma and would like to know more about the types of Medigap plans available in your state? Do you still have questions about how to decide on the right plan for you? Our team of licensed advisers are always ready to lend a helping hand. Get in touch with us at 1-800-791-0150 .
