Most people are lucky enough to have an Original Medicare (Part A and Part B) coverage. However, there are some situations where it falls short. It is at times like these that the Medicare Supplement Plans, Medigap, prove invaluable. The issue is that Medigap is only available for individuals who meet certain criteria. This then brings about the question; how do I know if I am eligible for the supplementary coverage? The answer can be found below.
When Is One Eligible for Medigap?
The first and most important thing is that you actually have an Original Medicare coverage. This is because Medigap is not a full coverage in itself, just a cover that supplements what you already have in place. This means that you need to either be enrolled in Part A or Part B beforehand and still remain enrolled. This will ensure that your medical and hospital coverage is taken care of. Medigap kicks in whenever there are some extra costs not taken care of by your Original Medicare.
There are some individuals under 65 that have Medicare. This may be as a result of amyotrophic lateral sclerosis, disability or end-stage renal disease. Such individuals may or may not be eligible for the Medicare Supplement Plan. Their eligibility is wholly dependent on the state that they reside in. this situation arises for the simple fact that not every state offers supplementary coverage to beneficiaries below 65 years.
Additionally, the Medigap plans don’t cover prescription drugs. In order to get prescription benefits, it is always advisable to enroll in the Medicare Prescription Drug Plan. This is a standalone plan that covers the specific requirement. There are some older plans that included the prescription coverage, but that section has in time been phased out. So, if you are a beneficiary of such a plan, it is advisable to upgrade to a more recent coverage like Part D.
Enrollment Periods and Their Effect on Eligibility
The Medicare Supplement Plans 2019 Open Enrollment Period is a grace period during which an individual enjoys their guaranteed-issue rights. This means that you can enroll in any Medicare Supplement Plans available to you. Things like underlying health issues or pre-existing conditions neither deny you coverage nor increase the charges you incur. This period is available to anyone. It automatically kicks in during the month that they turn 65, and goes on for an additional 6 months. However, you must have Medicare Part B to be eligible. During this period, your enrollment is all but guaranteed. However, in some instances, your insurance company may have you wait 6 months before the coverage kicks in. But, this mainly affects people with pre-existing medical conditions.
Once the open is over, you can still apply for the Medicare Supplement Plans at your convenience. This, however, comes without the protection of the guaranteed-issue rights. As such, you may be subject to medical underwriting, higher rates and in some cases, a denial of coverage.
With this information in hand, we hope that it will be easier for you to understand the issue of eligibility and know when best to apply for your Medicare supplement Plans in order to get outright acceptance.