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Health Insurance Medicare Supplement


The State Health Insurance Assistance Program (SHIP) provides free help to New Jersey Medicare beneficiaries who have problems with, or questions about their health insurance. SHIP is a statewide program administered by the New Jersey Department of Human Services with financial assistance through a grant from the U.S. Administration for Community Living.

Medicare Parts A and B ("Original Medicare") only cover some of your health care costs. That's where Medicare Supplement Insurance ("Medigap") comes in. Medigap plans cover some of the costs not covered by Original Medicare, like coinsurance, copayments and deductibles.

With the Senior Health Insurance Information Program (SHIIP) we advocate for, inform, educate and assist consumers on Medicare and related health insurance issues so they can make informed decisions and access resources to address their needs.

Medicare supplement insurance, sometimescalled Medigap, is private insurance that fills in the gaps left byMedicare. For instance, when you have ahospital or doctor bill, Medicare pays its approved amount first, then thesupplemental insurance pays other costs, such as deductibles and copays.

All insurance companies must offer the same benefits under agiven plan. In other words, MedicareSupplement Plan A will have the same benefits regardless of which company sellsit. However, the premium you pay forthat plan may differ from one company to another. It is important to note that most Medicaresupplement plans do not include dental or vision coverage.

An alternative to Original Medicare and Medicare supplementinsurance is Medicare Part C, or Medicare Advantage. These Medicare-approved health plans are runby private insurance companies and provide benefits for hospital, doctor, andother health care provider services covered under Original Medicare Parts A andB as well as supplemental benefits that vary by plan. The insurer receives money from Medicare andmay also charge you a premium in some cases, depending on the benefits covered.Medicare Advantage might require you touse certain doctors and hospitals.

Choosing the right Medicare supplement plan can becomplicated. There are a number ofquestions to ask. Talking with familymembers, friends, and a trusted financial adviser are good ideas before pickinga Medicare supplement plan, but you can get more information on Medicare's website. You can also visit the Pennsylvania Department of Aging's Medicare Counseling Program, which is licensed by the federal government to provide insurance counseling services to seniors.

Carrier contact information, and more information about the plan option is available at the State Health Insurance Assistance Program website, at The current Contracting Carrier is Horizon Blue Cross Blue Shield of New Jersey (Horizon). Horizon has information available online at -plan/medicare-supplement-plans.

Q: Who can explain these Medigap changes to meA: Contact your insurance agent or the insurance company if you have questions about your Medigap policy and the new changes in Medigap Plans. You may also contact HICAP (Health Insurance Counseling and Advocacy Program) at 1-800-434-0222 for answers to many health insurance questions. For information about Medicare or Medigap call: 1-800-MEDICARE (1-800-633-4227) or visit the Official U.S. Government Site for People with Medicare.

If you have other forms of health care coverage (like a private insurance plan, Medicare, Medicaid, or TRICARE), you can use VA health care benefits along with these plans. Learn more about how VA works with other health insurance.

No. As a result of the VA MISSION Act of 2018, we no longer need permission to bill health insurance providers for care related to a sensitive diagnosis (like alcohol or drug abuse, alcoholism, HIV or HIV testing, sickle cell anemia, or other diagnoses included in Public Law 38 U.S.C. 7332-protected information).

More than 62 million people, including 54 million older adults and 8 million younger adults with disabilities, rely on Medicare for their health insurance coverage. Medicare beneficiaries can choose to get their Medicare benefits (Part A and Part B) through the traditional Medicare program, or they can enroll in a Medicare Advantage plan, such as a Medicare HMO or PPO. Medicare Advantage plans provide all benefits covered by Medicare Parts A and B, often provide supplemental benefits, such as dental and vision, and typically provide the Part D prescription drug benefit. Many traditional Medicare beneficiaries also rely on other sources of coverage to supplement their Medicare benefits. Supplemental insurance coverage typically covers some or all of Medicare Part A and Part B cost-sharing requirements and, in some instances, provides benefits not otherwise covered by Medicare. Beneficiaries can also enroll in a Part D plan for prescription drug coverage, either a stand-alone plan to supplement traditional Medicare or a Medicare Advantage plan that covers drugs.

Medicare supplement insurance, also known as Medigap, provided supplemental coverage to 2 in 10 (21%) Medicare beneficiaries overall, or 34% of those in traditional Medicare (roughly 11 million beneficiaries) in 2018. As with other forms of supplemental insurance, the share of beneficiaries with Medigap varies by state. Medigap policies, sold by private insurance companies, fully or partially cover Part A and Part B cost-sharing requirements, including deductibles, copayments, and coinsurance. As of January 1, 2020, Medigap policies are prohibited from covering the full Medicare Part B deductible for newly-eligible enrollees; however, older beneficiaries who are already enrolled are permitted to keep this coverage. While Medigap limits the financial exposure of Medicare beneficiaries and provides protection against catastrophic expenses for services covered under Parts A and B, Medigap premiums can be costly and can rise with age, depending on the state in which they are regulated. Estimated average monthly premiums for Medigap policies range from $150 to around $200.

Compared to all traditional Medicare beneficiaries in 2018, a larger share of Medigap policyholders had annual incomes greater than $40,000, had higher education levels, were disproportionately White, and were in excellent, very good, or good health (Table 1). Only a small share of Medigap policyholders (2%) were under age 65 and qualified for Medicare due to having a long-term disability; most states do not require insurers to issue Medigap policies to beneficiaries under age 65. Federal law provides time-limited guarantee issue protections for adults ages 65 and older when they enroll in Medicare if they want to purchase a supplemental Medigap policy, but these protections do not extend to adults under the age of 65. Legislation has been introduced in the 117th Congress to require insurers to offer Medigap coverage to younger adults with disabilities when they first go on Medicare, and to others.

Compared to traditional Medicare beneficiaries overall in 2018, people with employer-sponsored retiree health coverage as a supplement to traditional Medicare were more likely to have had annual incomes greater than $40,000, had higher education levels, were disproportionately White, were more likely to be in excellent, very good, or good health, and were more likely to be age 65 or older (Table 1). Evidence suggests that employer-sponsored retiree health coverage has been on the decline.

SHIP provides free, impartial information to help consumers make decisions regarding health insurance options related to Medicare. We strive to help them be wise consumers and to get the most value for their Medicare health insurance dollars.

SHIP is staffed by a crew of volunteer counselors who have completed an intensive four-day training course and are certified by the IDOI. Regular training updates keep them current with the most recent changes in Medicare and other health care insurance options. Learn more about becoming a SHIP Volunteer. SHIP counselors are committed volunteers who offer you free and objective assistance in complete confidence.

Medicare Supplement Insurance, or Medigap, is sold by private companies, and helps pay some of the health care costs left after Original Medicare has paid its portion. Supplements cover items like copayments, coinsurance, and deductibles.

The Senior Health Insurance Counseling Program (SHIP) is a non-profit organization helping to inform the public about Medicare and other senior health insurance issues. This division provides accurate and objective counseling, assistance, and advocacy relating to Medicare, Medicaid, Medicare supplements, Medicare Advantage, long-term care, and other related health coverage plans for Medicare beneficiaries, their representatives, or persons soon to be eligible for Medicare. Call our Senior Help Line at 1-800-763-2828 for assistance.

For all persons on Medicare, there is a six-month open enrollment period once they reach the age of 65. During the open enrollment period, Medicare supplement insurance can be obtained regardless of your health condition.

If you are considering the purchase of a policy in addition to a Medicare supplement, you should review your insurance needs carefully to ensure you need additional coverage and how much additional coverage you may want or need.

Medicare Supplement insurance coverage helps pay some of your share of the health care costs not covered by the Medicare Plan; such as deductibles, coinsurance, and copayment amounts. Some Medicare Supplemental insurance plans also cover certain hospital or medical services not covered by Medicare.

Medicare Supplement Plan F, administered by Premera Blue Cross, allows the use of any Medicare contracted physician or hospital nationwide. The plan is designed to supplement your Medicare coverage by reducing your out-of-pocket expenses and providing additional benefits. It pays some Medicare deductibles and coinsurances, but primarily supplements only those services covered by Medicare. 59ce067264


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