Secondary Insurance for Medicare: Coverage, Benefits, and How it Works
It’s no secret that Medicare doesn’t cover everything. There are plenty of out-of-pocket costs that Original Medicare (Part A and Part B) doesn’t cover. That’s where secondary insurance for Medicare comes in.
Secondary health insurance for Medicare is a type of insurance that helps cover the costs that Medicare doesn’t. It can help cover things like deductibles, copayments, and coinsurance.
There are a few different types of secondary insurance for Medicare. One type is called a Medigap policy. Medigap policies are sold by private insurance companies and can help cover some of the out-of-pocket costs that Medicare doesn’t.
Another type of secondary insurance for Medicare is called a Medicare Advantage plan. Medicare Advantage plans are offered by private insurance companies and can help cover some of the out-of-pocket costs that Medicare doesn’t.
There are also secondary health insurance plans that cover long term care, dental coverage, hearing aids, and vision insurance.
In this blog post, I will explain what a secondary health insurance plan is and how it works with Medicare so you can decide if one might be right for you.
What is Secondary Insurance for Medicare?
Medicare supplements, also known as Medigap policies, are insurance plans that provide extra coverage for what Medicare includes. This means that if you have a supplement policy, it will cover some of the costs that Medicare does not.
For example, most policies will help pay for your Part A and B deductibles, as well as coinsurance and copayments.
It’s important to note that Medigap policies are always secondary to Medicare. This means that if you ever need to use your supplemental insurance policy, it will only kick in after Medicare has paid its share. And keep in mind that supplements are not supplemental insurance–they stand on their own and are not secondary to Medicare.
If you’re looking for supplementary insurance for your loved one who is covered by Medicare, it’s best to speak with a licensed agent who specializes in Medicare. They can help you compare rates and find the best plan for your needs.
How does Secondary Insurance Work?
Secondary health insurance coverage for Medicare is a type of supplemental health insurance policy that helps to cover the gaps in Medicare coverage. This can include costs like deductibles, coinsurance, or both.
There are many different types of plans available, so it’s important to read all of the fine print and choose the plan that best suits your needs.
Most people need to pay a monthly premium for their secondary insurance, depending on the type of plan and coverage chosen. Supplemental medical plans also have a deductible and coinsurance which share the costs with you after you meet the deductible.
Gap insurance plans help pay for deductibles or coinsurance. These policies are designed to help those who have high out-of-pocket costs associated with their primary insurance policy from Medicare.
Lump-sum insurance pays a cash amount, and it can be used however the person would like. This might be helpful if someone wants to use it towards medical expenses they’ve already incurred or if they want to save it for future needs.
Insurance carriers can ask about pre-existing conditions and deny coverage in certain situations. It’s important to remember that secondary insurance for Medicare is separate from the government’s primary insurance–so make sure you’re covered in all aspects!
How do Medicare Supplement Insurance Plans work with Original Medicare?
When you’re enrolled in Original Medicare, you’re also automatically enrolled in Part A (hospital insurance) and Part B (medical insurance). Part A covers inpatient care in hospitals, skilled nursing facilities, hospices, and home health care. Part B covers doctor visits, outpatient care, preventive services, and some home health care.
If you want to add coverage for things like vision or dental care that aren’t covered by Original Medicare, you can buy a Medicare Supplement insurance plan.
Most plans cover the Part A deductible at 100% however, some Medigap plans will only cover 50% of the cost. That means if you must pay your own deductible for hospital stays, your supplement plan may help pay for that.
The most popular secondary Medicare supplement plan is Medigap Plan G. Plan G is affordable and provides the most protection for new Medicare beneficiaries.
Supplemental insurance plans are offered by private insurance companies and each has its own letter designation–like Plan C or Plan F. The letter assigned to your supplemental plan indicates a different level of insurance coverage.
Most Medicare beneficiaries with Medicare choose a supplement plan that offers comprehensive coverage across all parts of Original Medicare. That way, they know their out-of-pocket costs will be more predictable.
What are the Coverage and Benefits of Secondary Insurance for Medicare?
Secondary insurance is common for those preparing to enroll in Medicare plans and can be purchased for the individual or family at most stages in life. It can help pay for services not fully paid for by Original Medicare.
Secondary insurance coverage includes:
- Medigap Plans
- Dental Insurance
- Hearing & Hearing Aid Coverage
- Long-Term Care Insurance
- Life Insurance with a long-term care rider
- Hospital Indemnity Plans
- Cancer Policies
- Accident Policies
Various insurance bundles are available to personalize your coverage. You can also get secondary insurance plans if you have low income or special needs.
What are the Eligibility Criteria for Secondary Insurance Policies?
The eligibility criteria for secondary insurance for Medicare is that you must be a U.S. citizen or a legal resident of the United States.
In addition, you are required to be enrolled in both Medicare Part A and Medicare Part B prior to enrolling into a Medigap plan or a Medicare Advantage plan.
Individuals younger than 65 years old and are receiving social security disability benefits for 24 months may also enroll in Medicare and obtain secondary insurance for Medicare.
If you meet all of these requirements, then you are eligible to apply for secondary insurance through a private insurance company.
There are additional eligibility requirements for long-term-care policies, dental insurance, life insurance, and cancer policies. They may require medical underwriting, age restrictions, pre-existing exclusions, and have waiting periods.
Integrity Now Insurance Brokers is an independent insurance agency that specializes in Medicare. They represent all Medicare insurance companies in your local area and provide competitive secondary insurance coverage for Medicare.
How Medicare Coordinates with Secondary Insurance Coverage
There are many different types of coverage available to people who have Medicare. It’s important to keep up with changes in your plan and to understand how Medicare coordinates with other coverage you may have.
Medicare will identify in their system what plans you are enrolled in. This includes a Medicare supplement plan, Medicare advantage plan, CHAMPVA, or Tricare. Medicare’s system will then identify what and how to pay your medical bills or not.
If you are a spouse of a 100% P&T veteran and enrolled in CHAMPVA, you need to notify CHAMPVA once you receive your Medicare card showing you have enrolled into both Medicare Part A&B. This will make CHAMPVA secondary to Original Medicare. This is equivalent to having a Medigap Plan F as you will pay zero out of pocket for all covered Medicare services.
If you sign up for a Medigap policy the private insurance company will notify Medicare that the insurance company is now secondary, and which plan you selected. That means that if you have a hospital stay, your supplemental insurance will pay after Medicare pays its share.
With a Medicare Advantage plan, the private insurance company is primary and there is no secondary payer. Original Medicare is 100% replaced by the Advantage plan.
Dental, vision, and hearing policies stand on their own and aren’t supplemental to Medicare; they’re separate policies that work together with your other health insurance plans.
Final Thoughts on Secondary Insurance Plans
All in all, having a supplemental insurance policy is a great way to make sure that you are covered in case of an emergency.
Having a Medigap plan to supplement Original Medicare is especially helpful if you have a lot of medical expenses or if you are planning on travel.
Obtaining other secondary insurance policies help protect you from unexpected expenses, by spreading out the cost through the insurance premium.
If you are interested in getting a policy, be sure to compare different options and find one that fits your needs and budget.
Integrity Now Insurance Brokers has licensed Medicare insurance agents that are here to help. Contact us today!