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Published on November 15, 2018

Darlene Bartscher and Pam Skals

Medicare Supplement: Picks up Where Medicare Leaves Off

Since turning 65, Darlene and Dick Bartscher have realized the importance of owning a Medicare Supplement Insurance policy.  “I know that I wouldn’t want to go without one,” Darlene says.

A Medicare Supplement policy provides Medicare beneficiaries the security of knowing that they have coverage for expenses that Medicare approves, but does not pay in full. For the Bartschers, having a  Medicare Supplement plan meant they haven’t had to pay for any medical expenses out of pocket, even after knee replacements and a hip replacement.

Why Supplement Medicare?

Medicare Supplement Insurance pays for some of the health care costs that Medicare doesn’t cover, such as coinsurance, co-pays and deductibles. It’s also known as a Medigap policy because it helps close the “gap” in Medicare coverage.

“A Medicare Supplement plan is designed to pick up where Medicare leaves off,” says Pam Skals, an Avera Health Plans Sales Associate. She encourages everyone enrolled in Medicare Part A and Part B to consider a Medicare Supplement plan.

“If you get sick or hurt without a Medicare Supplement plan, Medicare Parts A and B will pay, but then you’re responsible for any deductibles and a 20 percent coinsurance of an unlimited amount. That’s the scary part to me – the unknown amounts that you could be stuck paying without a Medicare Supplement policy in place.”

How to Shop for a Medicare Supplement Plan

Medicare Supplement policies are standardized, which means they offer the same benefits, no matter which insurance company sells it. However, keep in mind that insurance companies may charge different amounts for exactly the same Medicare Supplement policy. In addition, not all insurance companies offer all of the Medicare Supplement policies as there are up to 10.

That’s why it’s important to shop around and find not only a plan that’s best for you, but an insurance company that offers it at an affordable price, along with the level of customer service you need.

Additional questions to ask while shopping for Medicare Supplement include:

  • Does this insurance company offer a large provider network that allows me the freedom to choose providers close to home?
  • Is there a waiting period for prior health conditions?
  • Do they have local agents who will meet with me, answer my questions and help me apply?
  • If I’m traveling and get sick or injured, can I go to any Medicare-approved hospital or physician for emergency care while traveling?

If you travel internationally, be sure to ask about whether or not your plan covers certain benefits that Medicare doesn’t cover, like emergency foreign travel expenses.

Shopping Local Provides a Personal Touch

The Bartschers decided it was time to shop around after noticing a steady price increase in their premium over the past few years.

They checked into Medicare Supplement options offered by Avera Health Plans, based in the Bartschers’ hometown of Sioux Falls, SD. After meeting with agent Pam Skals, they learned they could have the same coverage, yet save about $1,000 per year.

“We met with Pam in person and she was very good at walking us through everything,” describes Darlene. “We really appreciated the personal touch that comes with working with someone local.”

Skals, who has been an insurance agent for over 20 years, says her main goal is to help people get the coverage they need at an affordable price.

“What I love most about my job is being able to meet people face to face and help them save money while ensuring they have the health care coverage they need,” she says. “It’s been wonderful working with Darlene. We had an instant connection, including one really neat thing in common – the fact that we both love to fish.”

When Is The Best Time to Buy a Medicare Supplement?

If you are 65 or older and enrolled in Medicare Part A and B, you can enroll in a Medicare Supplement plan at any time.

You can also take advantage of open enrollment periods offered by some companies. For example, from now until Jan. 15, 2019, Avera Health Plans offers a Medicare Supplement open enrollment period.

“That means we can help people get a policy in place with no health questions asked – even if they’re currently ill or have a prior health condition,” adds Skals. “Now is a great time to review your plan for 2019 and find out if you can save money.”

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