How to Buy an Individual Health Medicare Supplement Plans
Individual health Medicare Supplement plansis vital to help you pay for your healthcare when you get sick or injured. Keep in mind that the cost of an emergency visit can be thousands. Without a health plan, it can be difficult for you to handle all expenses.
Some people have gone through bankruptcy because of their medical costs. Thus, to avoid such a thing, make sure that you obtain a health plan to protect you against unexpected events.
Thankfully, there is the Affordable Care Act or Obamacare that can protect you and your family.
Getting a Health Plan
The open enlistment period for 2020 health plans in most states will start on November 1, 2019, and ends on December 15, 2019. You need to wait for that period to start before you can purchase a plan.
Before 2014, you could buy an individual health plan at any time. That is, there was no open enlistment to remember. But the healthcare reform changed that. Now, you need to buy coverage within the open enrollment period.
In some states, they extend the length of time in accepting people’s application for health insurance. For instance, in California, you are given from October 15, 2019, to January 15, 2020, to send your application.
These are the other states that offer extended open enlistment dates:
- Colorado and D.C.: Both start on November 1, 2019. However, the enlistment ends on January 15, 2020, in Colorado. In D.C., it stops on January 31, 2020.
- Massachusetts: The period starts on November 1, 2019, and stops on January 23, 2020.
- Minnesota and Rhode Island: They both start on November 1, 2019, and will end on December 23, 2019.
- New York: It begins on November 1, 2019, and ends on January 31, 2020. It is one of the longest open enrollment periods.
In some cases, you may miss the deadline. If you missed it, you cannot purchase a plan. You will have to wait for the next enrollment period. However, if you have a qualifying life event, you can purchase a plan outside the open enlistment dates.
To qualify for a special enrollment period, you need to have these qualifying life events:
- Getting married
- Moving to a new state
- Having a baby
- Adopting a child
- Job loss
- Losing eligibility for the Children’s Health Medicare Supplement plansProgram (CHIP)
- Becoming an Indian tribe member
If you think that you have a qualifying life event, make sure to talk to an Medicare Supplement plansagent to help you out. The tax penalty for not having health Medicare Supplement planshas been lifted. But you must have at least a medical coverage to protect you from financial loss in case you get sick or injured.
Coverage for Anyone
The health care reform mandates insurers to provide medical coverage for anyone, regardless of a pre-existing condition. In that case, you can have health insurance, despite being pregnant or suffering from a serious health condition. No insurers can deny you coverage. They are also not allowed to impose huge charges if you have a pre-existing condition.
- Outpatient healthcare
- Emergency room visits
- Mental health
- Equipment when recovering from a chronic condition
- Laboratory tests
- Pediatric services
- Preventive services
Individual Health Medicare Supplement plansTypes
Health Medicare Supplement plans varies depending on the healthcare costs that it can handle. They are divided into five categories under the Affordable Care Act marketplace. Here are the metal levels that you must be aware of:
- Bronze: You will pay 40% of the healthcare costs while 60% will be settled by your health insurer.
- Silver: Your share will be 30% and the health Medicare Supplement plansprovider will take care of the remaining 70%.
- Gold: Your insurer will pay 80% of the healthcare cost while the remaining 20% will be handled by you.
- Platinum: You will only pay 10% of the healthcare cost while 90% is paid by your health insurer.
If you want a higher premium, you will pay lower out-of-pocket expenses. This option is perfect if you do not go to your doctor or rarely visit a hospital. The expenses would include deductibles, co-insurance, and co-payments. After closely examining the metal state levels, the platinum plans will give you lower out-of-pocket expenses. However, the bronze level will require higher expenses but a lower monthly premium.
Among the four plans, the most popular ones are bronze and silver. Platinum plans are rarely chosen. The reason for this is the higher premium cost. However, these plans are useful if you frequently visit your doctor or hospital. In a report, eHealth stated that the average monthly cost of a bronze plan is $440 while silver is $482. The platinum plans have an average cost of $706 while gold has $596.
When deciding what metal level you choose, you must study your previous healthcare need and anticipate your medical care for next year. In terms of plan design, the most common is the Health Maintenance Organization (HMO). The Preferred Provider Organization is more common among employer-sponsored health policies.
Health Medicare Supplement plansOptions
You should go to comparison sites or contact a health Medicare Supplement plansagent if you are ready to purchase a plan. You may also visit your state’s health Medicare Supplement plansmarketplace. Another option is to go to the provider’s website directly. If you are qualified for subsidies, opt to purchase a health plan through the marketplace. You may qualify for a discounted premium.
What to Consider When You Compare Health Plans
How it is structured?
When you are in the process of picking a plan, you have four options to choose from. They are categorized into premium costs and out-of-pocket expenses. Once you have evaluated them, it will be easy for you to decide whether to choose a higher premium plan or out-of-pocket expenses.
Who belongs to the network plan?
Check your plan’s network to know which healthcare providers belong to the network. You may wish to consider a plan that includes your healthcare provider.
What to know about the coverage?
Each plan has its own coverage items. Make sure that you check the items. If you are taking a lot of medicines, opt for a plan that covers the drugs you are taking.
What are the out-of-pocket expenses?
There are three vital expenses you must know. The deductible is one. It is the payment that you must settle before your plan starts paying for your healthcare cost. The copayment is the amount you need to pay each time you visit a hospital or doctor’s office. Co-Medicare Supplement plansis the percentage of healthcare costs after you have met the deductible.
What is the yearly Premium?
Make sure to study the yearly premium of the plan you wish to obtain. When considering a plan, always compare it with your current healthcare needs. Then, evaluate the cost of premiums as well as out-of-pocket expenses you can afford.