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Supplemental Insurance policies offer benefits
not covered by Medicare


There are a variety of private insurance policies designed to supplement basic Medicare insurance. Regulated by state and federal agencies, a Medigap Insurance Policy may pay for services only partially covered by Medicare, and offer coverage for other treatments and services not approved by your Medicare policy. To simplify the selection process a basic benefit package known as Plan A must always be made available. Nine additional plans - B through J - offer enhanced coverage in addition to the basic benefits outlined in Plan A.
All ten policies are standardized to allow for easier cost comparison. Individuals who purchased a Medicare Supplement before 1992 have alternative coverage.

A complete list of companies approved to sell Medigap policies in Colorado can be obtained by calling the Colorado Division of Insurance at 303-894-7552 or at their website .

PLAN A or the basic supplemental insurance policy must:

  • Be guaranteed renewable (except for non-payment of premiums).
  • Provide co-insurance for hospitalization (Medicare Part A) for days 61 through 150 days.
  • Cover the cost of the first three pints of unreplaced blood.
  • Pay 20% of the Medicare approved charges for Part B after the annual deductible of $100 is paid.
  • Have no waiting list for pre-existing conditions for first time enrollees aged 65 or more; and no more
    than a six month waiting period regardless of other circumstances.
  • Have a 30 day fully refundable premium.


    Plans B through J offer the following benefits in addition to the items covered in Plan A:
    Additional Benefits Offered in Plan: B C D E F G H I J Additional Benefits Offered in Plan: B C D E F G H I J
    Part A Deductible x x x x x x x x x At Home Recovery     x     x   x x
    Part B Deductible   x     x       x Preventive Health Care       x         x
    100% of Part B Excess   x           x x Basic Drugs ($1250)             x x  
    80% of Part B Excess           x       Extended Drugs ($3000)                 x
    Skilled Nursing Co-insurance   x x x x x x x x Foreign Travel Emergency     x x x x x x x

    Comparison Shopping

    Because Medigap Plans are standardized, cost and reputation of the insurance company are the two factors to be considered before deciding to buy. Insurance companies price Medigap plans according to several factors, including the age of the individual, and projected rate of inflation and resultant increase in medical costs. In addition to cost comparisons, the purchaser should consider the financial stability of the insurance company and the integrity of the sales representative.

    Steps to take before choosing a Medigap insurance policy

    Research the Insurance Company

    1. Check with an independent research company such as Standard and Poor or Weiss Research, Inc.  for financial ratings. Call the library or Colorado Division of Insurance (303-894-7552) for referral.

    2. Ask your physician(s) bookkeeping department how efficiently the company processes claims.

    3. Make a point to review the company's billing procedures and make certain they are acceptable to  your way of doing things.

    Don't do business with an insurance agent (or company representative) who:

    1. Is unable to explain the policy and answer all questions to your satisfaction.

    2. Doesn't remind you of the "free look" period (during which time you may cancel and get a  full refund of your premium).

    3. Acts impatient or tries to rush you into making a commitment.

     

    WARNING: Comparison shopping of any kind will likely precipitate telephone conversations and contact calls from people with whom you are not familiar. Never give any information over the telephone. Just one piece of data such as your social security number, birth date or other personal identification numbers can be used to illegally obtain another. Make it a rule to only provide this type of identification in writing on appropriate documents or applications.

    To purchase a Medicare Supplement or a MediGap policy, you can compare companies offering plans at http://www.medicare.gov/mgcompare/home.asp.

    In Colorado, you can get additional information at http://www.dora.state.co.us/Insurance/ by clicking on Menu, then clicking on Senior Health Insurance.



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Senior Answers and Services and Colorado Gerontological Society are not for profit organizations dedicated to education and the dissemination of information pertinent to seniors and professionals in the field of aging. Correspondence or questions regarding the information on this site should be forwarded to:

Eileen Doherty M.S., Executive Director
3006 East Colfax, Denver, CO  80206 *  303.333.3482 ** 303.333.9112 (fax)

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