It’s no secret that Vermont is the second least populated state in the United States, but few people know that the state also has the second highest median age. Perhaps it’s the crisp mountain air or the relaxed atmosphere, but seniors in Vermont seem to be living longer, and most are eager to enjoy their lives to the fullest. One way to ensure that seniors have more money for leisure pursuits is to spend less on health care costs, and Medicare and Medicare supplements allow for just this possibility. Still, if you’re a Vermont senior looking for a proper health insurance policy, it’s imperative to know your options before making a commitment. The information below will explain a bit about what Medicare supplements are available in Vermont so that you’ll feel confident when making your decision.
Medigap is a Medicare supplement that is available in ten variations, each of which follows strict guidelines set forth by the federal government which stipulate what services are covered by each plan. Medigap plans are provided by private health insurance companies, each of which sets its own price for each plan. In other words, Vermont seniors who wish to enroll in a Medigap plan should compare prices diligently in order to find the plan with the best price. Vermont Medigap plans range in price from under $50/month to over $200/month, depending on the price and the insurance agent. However, seniors should not select a plan based upon price alone. They should consider what services they want covered, and weigh the benefits of the services with the cost in order to make a practical and proper decision. For example, seniors in good health may want to choose a plan that offers travel insurance, a benefit that is offered through four Medigap plans. Alternatively, seniors who are not in the strongest of health may want to consider a plan with full hospice coverage rather than a plan that offers limited hospice coverage, as is offered by Medigap Plans K and L.
According to research conducted by the Kaiser Family Foundation, Vermont’s Medigap system is among the weakest in the country, with the average plan being rated only 2.5 stars out of a possible five stars. Interestingly, nearly 40,000 of Vermont’s seniors are still registered for Medigap policies, as compared with only about 5,000 Vermont seniors that choose Medicare Advantage.
Vermont Medicare Advantage
Medicare Advantage, also known as Medicare Part C, differs from Medigap because it primarily covers costs that are not covered by Medicare Parts A and B, while Medigap covers these costs and offers other supplemental coverage (such as coverage of extended hospital care and blood transfusions). Medicare Advantage plans are available in PPO, HMO and FFS versions, and policies are more flexible than Medigap plans as they are not as strongly regulated. Therefore, Vermont seniors that are looking for coverage of specific services or physicians can look for a plan that will accommodate their needs, though it should be noted that most Medicare Advantage plans only cover services provided by a Medicare approved physician.
Like Medigap, Medicare Advantage plans are sold by private insurance companies, and prices vary from plan to plan and company to company. Medicare Advantage plans are not congruous with Medigap, so Vermont seniors must choose between the two options.
Things to Consider
Both Medigap and Medicare Advantage plans have a guaranteed acceptance policy when registration takes place during the senior’s open enrollment period (the time surrounding his or her 65th birthday). Only seniors with end stage renal disease may not qualify for either Medicare supplement. Seniors who do not wish to register for a Medicare supplement immediately can reevaluate their decision annually, and register during the nationwide open enrollment period, which is generally between October 15 and December 7. Plans selected during this time will be activated on January 1 of the following year. Open enrollment times are subject to change but have been set during this time for the past few years.
All Vermont seniors are entitled to a free look, which means that they can cancel their Medicare supplement policy at any time within the first month for a full refund. However, since enrollment is restricted to specific times of year, all registrants who wish to cancel their Medicare supplement plan should consider this decision strongly before cancelling.
As healthcare costs continue to rise in America and more healthcare options become available annually, it’s important to consider not only what services you need and afford now, but what type of coverage you will want in the future. Think about your lifestyle, your health circumstances, your retirement budget and the physicians available in your area in order to make the right choice.
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