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National Association of Medical Supplement Advisors

Medigap FAQs

Why are premiums different company by company for the same plans?

Premiums are calculated based on claims history, the amount a company has actually paid in claims and the claims loss ratio used by a particular company as well as other factors. A company that adheres to the Medicare suggested 65% claims loss ratio may appear to be higher than a company that employs a higher ratio, but the company with the 65% ratio will actually be cheaper over the years than the one that has a higher ratio because they are charging the proper amount continuously compared the other company who will have to have large rate increases in order to pay claims and stay solvent. The key factor to look at is the percentage amount of increases per company over the years. The company with the lowest percentage is actually the cheapest in the long run.

What is the difference between Issue Age, Attained age and Community Rated?

Issue age premiums are based your age at the time of issue, premiums are lower for people who buy at a younger age and won’t change as you get older. Premiums may go up because of inflation or other factors, but not because of your age.

Attained age premiums are based on your current age and go up each year as you get older, are low for younger buyers but go up as you get older and eventually become the most expensive. Premiums may also increase because of inflation and other factors.

Community rated generally have the same monthly premium for everyone who has a policy regardless of age and can go up based on inflation or other factors, but not age.

What if I move to another state, can I take it with me or will I need a new policy?

All standard Medicare supplement plans are portable, so there is no need to change when moving.

I am turning 65 and have some health issues, will I pass under writing?

Have no fear, you have an open enrollment period when you first enroll in Part B weather at 65 or older, during this period, you are guaranteed coverage regardless of any current or pre existing conditions. All waiting periods for preexisting conditions are also waived.

My group insurance has gotten very expensive and I can save money with Medicare and a supplement, but I have some health issues.

You have guaranteed issue rights for a supplement with all health conditions accepted and any waiting periods waived regardless if it’s voluntary or involuntary. You must enroll in a supplement within¬† 63 days of leaving the group plan.

Can I travel within the U.S. with a Medicare Supplement?

Yes. One of the main advantages of a Medicare Supplement is the ability to go to all Doctors, Hospitals, and Specialists nationwide. As long as the doctor accepts Medicare, you can use any companies Medicare Supplement for secondary coverage.

Can I change a Supplement at anytime?

Yes. A Medicare Supplement can be changed at anytime during the year. While a Medicare Advantage plan can only be changed during the open enrollment which is from Oct. 15th to Dec. 7th.

How and when can I change my part D prescription plan?

Part D plans can only be changed once a year during the open enrollment period which runs from Oct. 15th to Dec. 7th.

Does Medicare work outside of the country?

Medicare does not work outside of the country. However when you have a Medicare Supplement you have coverage for emergencies for the first 60 days of your trip. That coverage has a $250 deductible and a $50,000 maximum. If traveling for an extended period of time it is recommended to also get additional travel insurance.

How do I know my doctor will take your plan?

When you have a Medicare Supplement as long as your doctor accepts Medicare he has to take your Supplement regardless of the company. However when someone is enrolled in a Medicare Advantage plan the doctor must carry that specific plan in order for you to be able to see that doctor.