We feel that the best care is received when you have your choice of Doctors, and you and your Doctor make your medical decisions. Medigap plans are available with no medical underwriting during your open enrollment period. This is when you become eligible for Medicare Part B. You may however, apply to a company and fill out the medical underwriting questions at any time. The Federal Government has this site to help you Compare Benefits.
Medicare Supplemental Insurance (Medigap or MedSup) is specifically designed to supplement Medicare's benefits and is regulated by federal and state law, It must be clearly identified as Medicare supplemental insurance and it must provide specific benefits that help fill the gaps in your Medicare coverage. Other kinds of insurance may help you with out-of-pocket health care costs but they do not qualify as Medigap plans.
We understand that shopping for insurance can be a very confusing process. We take our job very seriously and do everything we can to be sure that you understand the plan that you purchase. We strive to be your agents forever, and promise to be there to offer our advice and insight. You can contact us using the links above if you need more information or advice in choosing the right plan for you.
Part B Premiums - Higher income
** If you bought Plan E, H, I, or J before June 1, 2010, you can keep that plan.
Medicare Supplemental Insurance (Medigap or MedSup) is specifically designed to supplement Medicare's benefits and is regulated by federal and state law, It must be clearly identified as Medicare Supplemental Insurance and it must provide specific benefits that help fill the gaps in your Medicare coverage. Other kinds of insurance may help you with out-of-pocket health care costs but they do not qualify as Medigap plans.
In Washington there are more than 25 companies that sell Medigap Plans. We represent many of them. It is important to us that we can offer the best value to our clients.
"The Cost of Medigap policies can vary widely. There can be big differences in the premiums that insurance companies charge for exactly the same coverage."
From the page 19 of the Federal Choosing A Medigap Policy Brochure
To make it easier for you to compare Medigap insurance policies, all states (except Minnesota, Massachusetts and Wisconsin), U.S. territories and the District of Columbia limit the number of different Medigap policies that can be sold in any of those jurisdictions. The plans were developed by the National Association of Insurance Commissioners and incorporated into state and federal law. They have letter designations," with Plan A being the "basic" benefit package. Each of other plans includes package plus different combination additional benefits. Insurance companies are not permitted to change benefits letter designations of any of the plans.
Medicare is a national health insurance program for people 65 years of age and older, certain younger disabled people and people with permanent kidney failure. Medicare is run by the Centers for Medicare & Medicaid Services . The Social Security Administration helps CMS by enrolling people in Medicare and by collecting Medicare premiums.
Medicare is divided into two parts: Hospital Insurance (Part A) and Medical Insurance (Part B). Part A helps pay for care in a hospital, skilled nursing facility, some home health care, and hospice care. Part B helps pay for doctor bills, outpatient hospital care and other medical services not covered by Part A. Your Medicare card shows the Medicare coverage you have--Hospital Insurance (Part A), Medical Insurance (Part B), or both--and the date your coverage started.
The 2016 Medicare Part A deductible is $1,288 and the 2016 Part B deductible is $166. Part B annual increases are based on Part B medical cost increases and are related to income levels.
Part A: (Hospital Insurance) Premium
Part B: (Medical Insurance) Premium
Most existing beneficiaries will be "held harmless" and will pay $104.90 in 2016. Beneficiaries not subject to the “hold harmless” provision will pay $121.80, as calculated reflecting the provisions of the Bipartisan Budget Act signed into law by President Obama last week. Medicare Part B beneficiaries not subject to the “hold-harmless” provision are those not collecting Social Security benefits, those who will enroll in Part B for the first time in 2016, dual eligible beneficiaries who have their premiums paid by Medicaid, and beneficiaries who pay an additional income-related premium. These groups account for about 30 percent of the 52 million Americans expected to be enrolled in Medicare Part B in 2016.
If your income is above $85,000 (single) or $170,000 (married couple), then your Medicare Part B premium may be higher than $121.80 per month.
Part A: (pays for inpatient hospital, skilled nursing facility, and some home health care) For each benefit period Medicare pays all covered costs except the Medicare Part A deductible (2016 = $1,288) during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days.
For each benefit period you pay:
Skilled Nursing Facility Coinsurance
Part B covers Medicare eligible physician services, outpatient hospital services, certain home health services, durable medical equipment
(please see the CMS information on this)
Enrollment in Medicare is handled in two ways: either you are automatically enrolled or you must apply. If you are getting Social Security or Railroad Retirement Board benefits before you turn 65, you are automatically enrolled and your Medicare card will be mailed to you about three months before your 65th birthday. If you are not receiving retirement benefits, you must apply by contacting a Social Security Administration office or, if appropriate, the Railroad Retirement Board. You should apply three months before your 65th birthday to avoid a possible delay in the start of your coverage. If you have been a disabled beneficiary under Social Security or Railroad Retirement for 24 months, you will automatically get a Medicare card in the mail.
Additional Medigap Information
- Medigap Plan F offers a high deductible option. You must pay for Medicare-covered costs up to the high-deductible amount ($2,180 in 2016) before your Medigap policy pays anything
- 100% part B coinsurance except up to $20 copayment for office visits and up to $50 copayment for ER.
- You must also pay a separate $250 deductible for foreign travel emergency and there is a $50,000 lifetime maximum benefit.
- After you meet your out-of-pocket yearly limit and your yearly Part B deductible ($166 in 2016) the plan pays 100% of covered services for the rest of the calendar year (This applies only to plans K & L) - [Excess charges do to apply to maximum out of pocket]
- Modified Plan F offers an individual assistance program, as well as coverage for preventive dental care (available in some states)
- 2016 Out of Pocket Limit for Plan K is $4,960.
- 2016 Out of Pocket Limit for Plan L is $2,480.
- You must be enrolled in both Medicare Part A and Medicare Part B and live in the plan's service area to be eligible for these plans.
- You are first eligible during the 7-month Initial Coverage Enrollment Period (ICEP), the 3 months before your 65th birthday, the month of, and 3 months after. CAUTION: You only have one choice so take your time, ask for help and choose wisely.
- You must continue to pay your Medicare Part B premium in addition to any plan premium shown below.
About Information Presented
- This is a web site from CDA Insurance LLC. CDA Insurance LLC is not an insurance carrier, we are an agency that represents many companies offering products to the general public and also to medicare recipients. We do our best to assure that all information presented on our web site is current and accurate.
- CDA Insurance LLC is not associated with Medicare or the Center for Medicare and Medicaid Services. This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE or consult www.medicare.gov.
- A Medicare Supplement plan is a health insurance plan provided by a private company that fills in the “gaps” in original Medicare coverage. CDA Insurance LLC is an agency that sells Medicare Supplement plans to medicare beneficiaries. Submitting our online quote request form does NOT affect your current enrollment, nor will it enroll you in a Medicare Supplement plan or other Medicare plans. To apply for coverage you must submit an application for the company and plan that you want.
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