Original Medicare, also known as Medicare Part A and Part B, only covers 80% of the total cost of approved services and procedures for hospital and medical care. The other 20% of your health care costs are your responsibility. This is where Medigap comes in. By purchasing a supplemental Medigap plan, you can cover the remaining costs of your care and receive the services and treatments you need. Please contact SBI Benefits to meet with our insurance agent and find out more about Medicare Supplemental Plans in Las Vegas and Sparks, Nevada!

What Is a Medicare Supplemental Plan? +

A Medicare Supplemental Plan, or Medigap, is an additional insurance policy that you can purchase from an independent, private insurance company to cover the remaining 20% of your health care costs. There are several plan options for supplemental care available to meet your needs, and our insurance agent will be happy to discuss your options with you to find the plan that is right for you.

Supplement vs. Advantage +

Medigap or a Medicare Supplement Plan, is only available for qualified citizens or permanent residents who have already enrolled in Medicare Parts A and B. Individuals who have opted to enroll in Medicare Advantage Plans or Medicare Part C do not qualify for this supplementary plan.A Medicare Advantage Plan may be more advisable for people who will not be financially at risk for high out-of-pocket costs, who want certain benefits that only come with a private health insurance plan and who are more personally involved with the intricacies of their Medicare policies. A Medicare Advantage Plan:

  • Requires you to seek “in-network” care from professionals and institutions recognized by your plan’s network.
  • Often already has a variation of prescription drug coverage (Medicare Part D) included in the plan.
  • Is purchased entirely through private institutions or through employers in partnership with private insurance companies or providers.

Medigap supplemental insurance is designed more for those who wish to have their risk of out-of-pocket costs reduced, who want accessible and constitution nationwide Medicare coverage and desire a more straightforward and “hands-off” relationship with their insurance policy. A Medigap plan:

  • Does not rely on a specific network of doctors and hospitals.
  • Gives you the option of choosing your own prescription drug coverage plan under Medicare.

Which type of plan you choose depends on your lifestyle, health history, financial stability and personal preference. Our insurance agent can help you stay fully informed of every available option so that you can choose the best plan for your needs.

What Does Medigap Cover? +

There are ten different lettered Medicare supplement insurance (Medigap) plans: A, B, C, D, F, G, K, L, M and N. Medicare supplement insurance programs cover 100% of Part A coinsurance. Part B benefits and coverage vary from plan to plan depending on how comprehensive the benefits package is. The cost of the plan will also vary from company to company. However, as Medigap is provided by private insurance companies they are required by law to offer the same basic benefits packages per lettered plan.Medigap generally does not include certain hospital and medical services such as long-term stays, dental care, vision care, etc. under its Medicare coverage. Medical technology such as hearing aids and prescription glasses, etc. are not typically covered. Please speak with an insurance agent to determine your benefits and coverage under the different plans available to you.

Qualifying for Medigap +

You qualify for Medigap if you:

  • Are enrolled in Original Medicare (Medicare Parts A and B)
  • You are a natural citizen or been a permanent resident of the United States for at least 5 years.
  • You are 65 years old.

If you were eligible for Medicare plans before age 65 due to disability or disease you may not be eligible to purchase a Medicare supplemental health insurance policy. However, there are still some Medigap plans and benefit packages that may be available to you. Please consult with our insurance agent for more information on supplemental Medicare coverage and which plan is right for you.

Choosing the Right Plan for You +

The basic benefits for lettered Medigap plans are standardized by federal law, making a Medicare supplement Plan F in Las Vegas, Nevada, the same as a Medicare supplement Plan F in other cities and states. However, not every Medicare insurance company will offer every Medigap plan and standardized benefit package. Some companies will only offer the supplemental plans that are more popular in your zip code, and more comprehensive Medicare supplement policies will also have higher premiums.It is up to you to consult with an insurance expert, such as our agents here at SBI Benefits, to determine which Medicare supplement benefit package is the best fit for you, your family and your lifestyle.

When To Get a Supplemental Plan? +

Just as with Medicare Parts A and B, the enrollment period and rules involved with supplemental Medicare coverage is standardized by federal law. Qualified citizens and permanent residents have the legal, guaranteed right to purchase a Medicare supplement insurance plan during a six-month period: the three months before their 65th birthday and the three months after. If this enrollment period is missed insurance companies have the option to deny Medicare supplement policy purchase due to pre-existing conditions or other health factors.However, if you qualified for Medicare prior to your 65th birthday due to disability or disease your first Medigap window is the date of your insurance coverage activation. This is not a guaranteed right but does offer you more options. The second window of enrollment that becomes your legal right is during the same six-month period surrounding your birthday.

Drug Plans and Medigap +

Medicare supplement plans cover only Part A and Part B. Part D (prescription drug coverage) is an entirely different plan that you must enroll in separately from your regular Medicare coverage. Most healthcare professionals high advise enrolling for Part D coverage, even if you do not take regular prescription medications at age 65. This is because failing to enroll in Medicare Part D outside the specified enrollment period may result in penalty fees.Medicare supplements plans give you the freedom to choose and compare between drug plans in your state and find the plan that is right for you.

How To Choose a Medigap Plan? +

The enrollment period for purchasing Medicare supplemental health insurance falls under a relatively strict timeframe. Please take the time to learn your options so you can find the right supplemental plan for you.After you have found the Medicare and Medigap plan that is right for you, take some time to compare pricing between Medicare-focused companies. These companies are federally required to offer the same basic benefit packages for the same lettered plans, so make sure that these plans match up.

We recommend that you consult with our insurance agent as well as other agents, agencies and insurance companies that specialize in Medicare so you can make the most informed decision possible.