When you become eligible for Medicare, you have a choice of purchasing original Medicare, Medicare supplemented with a Medigap policy, or a Medicare Advantage Plan. A Medicare Advantage Plan is a private-sector alternative to original Medicare that generally includes the benefits of a Medigap policy as well, but often has a PPO or HMO structure. Joseph Baker, president of the Medicare Rights Center, a national consumers’ advocacy group, says, “Traditional Medicare with a Medigap policy is still the gold standard, if you don’t have coverage from a former employer.”
You can choose any one of the 10 Medigap plans established by the federal government. The Medigap Benefits Chart on our site shows the basic distinctions between the plans. You can receive free counseling to help determine which plan is best for your short- and long-term needs. The New Mexico Aging and Long-Term Services department coordinates free counseling events at senior centers throughout the state. You can find a schedule here. For individual advice, contact the State Agency on Aging online or at 1-800-432-2080. The New Mexico Benefits Counseling Program is the official State Health Insurance Program (SHIP) that provides counselors.
Our Web site also provides a quick and simple way to receive rate quotes on Medigap policies from multiple insurance companies. You need to know two important things about Medigap policy pricing. First, each of the 10 plans provides the same insurance coverage regardless of which insurance company provides the coverage. Yet, prices vary considerably. Second, insurance companies price policies by using the attained-age method (86% of the plans sold in New Mexico use this method); the issue-age method; or the community-rating method. With the attained-age method, you pay relatively low premiums in the early years, but rates rise as you age. With the issue-age method, your premiums are permanently based on your age at the time you originally buy the policy. With the community method, all enrollees pay the same premium, regardless of age.
All AARP HealthCare Options (United Healthcare Insurance Company) plans are community-rated and they are the only community-rated plans sold in New Mexico. You can choose attained-age-rated or issue-age-rated plans from many carriers.
Blue Cross Blue Shield of New Mexico and AARP HealthCare Options will sell all marketed plans to Medicare recipients under age 65; Old Surety Life Insurance Company will sell Plan A to that younger age group.
Exercise care in choosing an insurance company. Insurance fraud has been a problem in New Mexico. The New Mexico Division of Insurance received complaints about health insurance policies being marketed by companies that haven’t been authorized by the state to do so. You can easily check to see if a company is licensed by entering the company name in the division’s search tool.
Once you’ve narrowed your choices of insurance carrier, you can call the Consumer Relations Division of the New Mexico Public Regulation Commission at 1-800-663-9782 to find out how many complaints the division has received about those companies.
Note that if you are married, you and your spouse will need to buy separate policies.
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