Oregon Medigap Insurance
The simple truth is that Medicare does not pay for everything. The “gaps” in Medicare coverage can represent a significant cost if one considers just the coinsurance and deductibles. In the event of a catastrophic illness, the expenses can be a financial hardship. For peace of mind and to help budget medical costs, many people purchase Medigap Insurance Oregon plans, as known as “Medicare Supplement insurance”.
What are Oregon Medigap Insurance Policies?
Oregon Medigap policies come in a variety of plans offered by numerous insurance companies. The federal government allows insurance companies to sell 10 Medigap plans, one of which has an option for a high-deductible plan. Oregon Medigap Insurance providers are under no obligation to sell every plan, but they must sell Plan A. Plan A does not include payments for deductibles, but it does cover co-pays for Medicare Parts A and B. Individuals must compare the costs and benefits of each plan to determine the plan that best addresses their needs.
Who is Eligible for Oregon Medigap Insurance?
To purchase a Medigap Oregon policy, applicants must be covered by Medicare Parts A and B. If individuals have a Medicare Advantage plan, they cannot buy an Oregon Medigap policy until they drop it and go back to parts A & B.
Can Companies Reject Applicants for Medigap Insurance Oregon Plans?
During certain periods, companies cannot refuse to sell individuals a plan. There is a six-month window that is in force when the individual first qualifies for Medicare Part B, another when the person turns 65 and another that covers individuals awarded retroactive Medicare coverage due to a disability. Certain uncommon circumstances can also provide guaranteed acceptance for approximately two months, such as individuals who lose their employer coverage at no fault of their own.
What Determines the Premiums for Medigap Insurance in Oregon?
Insurance companies assign rates based on pools of covered individuals. Normally, the smaller the pool, the higher the premiums will be. Oregon Medigap Insurance companies are allowed to create pools based on states, for example, which may result in higher premiums. Other factors that determine the cost of premiums include the insured party’s age, tobacco use, gender and past or current medical conditions. Companies can increase premiums as many times as they want with the Oregon department of insurances approval. Premiums for most Oregon Medigap plans are rated on attained age, which means that premiums can increase annually not only due to age but also inflation. A few providers offer plans that have premiums based on the person’s age at the time the policy was issued. These typically cost more during the first few years, but premiums do not increase as the individual ages although insurance companies can raise the rates based on payments for medical costs, inflation and other factors.
Can People with Current Health Problems Purchase Medigap Insurance Oregon Policies?
During the six-month period in which applicants are guaranteed acceptance, companies cannot deny coverage for current or past health issues. Beyond that period, insurance companies can refuse to cover an individual. Companies may also limit the person’s plan choices or require a waiting period before benefits start. In addition, they can charge higher premiums to individuals with known medical problems.
Do Medigap Insurance Plans Cover Prescription Drugs?
Prescription drug coverage is not normally included in Medigap Oregon plans. However, if the plan provides for hospice care, some plans will pay limited benefits for certain prescriptions. Purchases of Oregon Medigap plans are eligible to add a “stand-alone” prescription plan for an additional premium. It is not necessary for them to purchase the prescription plan from the same company selling the Medigap Oregon policy.
Are Medigap Policies the Same as Medicare Advantage Plans?
Medigap policies and Medicare Advantage plans are entirely different. Medicare Advantage plans are also known as Medicare Part C. This option is normally selected in lieu of a Medigap policy. Medicare Advantage plans require participants to see only providers who are members of the network. Participants in Medicare Part C are ineligible for Medigap Insurance Oregon policies. Medicare Advantage and Medicare Supplemental insurance plans are completely different types of plans.