Delaware Medicare Supplemental Insurance

With the rising cost of healthcare and higher life expectancies worldwide, the need for comprehensive coverage during one’s senior years has never been greater.  Though Medicare certainly covers many health-related expenses, there are many things it doesn’t cover, including out-of-network service providers and expenses such as copays, deductibles and coinsurance.  As with all forms of insurance, consumers shouldn’t wait until the need arises before purchasing a policy, as this can raise costs or restrict available services.  Instead, seniors or those nearing age 65 should consider investing in an insurance plan that will supplement their Medicare coverage.

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In Delaware, as in most states, there are two primary options for Medicare supplements.  According to research conducted by the Kaiser Family Foundation, the more popular option in Delaware is Medigap, a federally-regulated Medicare supplement that is available in 10 different plans (known as Medigap Plans A, B, C, D, F, G, K, L, M and N).  According to the Foundation’s research, over 30,000 Delaware residents are enrolled in a Medigap plan, accounting for about 21% of the state’s Medicare beneficiaries.  Perhaps one reason for this is that all plans have guaranteed acceptance, which means that consumers can apply even with preexisting health conditions.

Each Medigap plan offers specific coverage, and each plan is uniform throughout Delaware and throughout the country.  Full coverage of Medicare Part A deductibles is available in Medigap plans B, C, D, F, G, and N, and partial coverage of Medicare Part A deductibles is available with Medigap plans K, L and M.  Plans C, D, F, G, K, L, M and N also offer full or partial coverage of nursing home coinsurance, depending on the plan.  Delaware seniors who hope to enjoy their golden years may also want to consider a Medigap plan that offers travel health insurance.  This service is available in plans C, D, F, G, M and N, but it should be noted that Medigap covers only 80% of health-related expenses for traveling seniors, after a $250 deductible is met.

The Other Option

An alternative Medicare supplement available in Delaware is Medicare Advantage, plans which provide not only coverage of copayments and coinsurance like Medigap plans do, but also wider choices for patients looking to expand their coverage for out of network doctors and services such as dental coverage that are not covered by Medicare.  According to U.S. News & World Report from 2010, Delaware Medicare Advantage plans in Delaware were rated with an average of 2.5 out of 5 stars.  Perhaps it is not entirely surprising then, that the Kaiser Family Foundation estimates that only about 5,000 Delaware residents have chosen Medicare Advantage, a scant sixth of those who have chosen Medigap plans.

Nevertheless, Medicare Advantage does offer certain benefits that cannot be received through Medigap, such as a choice between coverage by an HMO, PPO or fee for service plan, as well as coverage of expenses such as hearing tests, dental care and acupuncture.  Prices for Medicare Advantage vary from insurance company to insurance company, and from plan to plan, so Delaware seniors should do their homework carefully before committing to a specific plan.  This research is even more important because of the restricted dates during which seniors can register for a Medicare supplement or switch their plan.  The nationwide open enrollment period for supplemental Medicare insurance is from October 15-December 7, and Delaware is no exception.  Consequently, consumers will not be able to change plans for about a year after enrolling, which makes it imperative that they make a comfortable decision from the get go.  Don’t panic though – there are some times in which Delaware residents can apply for a Medicare supplement even when enrollment is closed.  Such cases would include a move across county lines during the year, which would require the issue of a local Medicare Advantage plan, or the loss of a job that had provided health coverage.  Likewise, seniors who are within 6 months of age 65 can register during their own ‘personal’ enrollment period, without waiting for October to arrive.