Michigan Medicare Supplement Buyer's Guide
Michigan Medigap policies can help pay your share of your medical expenses such as coinsurance, copayments, and deductibles of Medicare-covered services. Some Medigap policies cover certain costs not covered by the Original Medicare Plan.
Quick Review of the Michigan Medicare Program
Medicare is health insurance for people 65 or older, those under 65 with certain disabilities, and those of any age with End-Stage Renal Disease. Medicare will cover many health care services and supplies, but there are many costs or "gaps" that it won’t cover.
Basic Parts of Michigan Medicare
| Part A (Hospital Insurance) |
helps cover your inpatient care in hospitals, skilled nursing facilities, hospice care, and some home health care if you meet certain conditions.
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| Part B (Medical Insurance) |
helps cover medically-necessary services like doctor’s services and outpatient care, other medical services that Part A doesn’t cover such as physical and occupational therapists, and some home health. Part B also helps cover some preventive services to help maintain your health and to keep certain illnesses from getting worse.
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| Part C (Michigan Medicare Advantage Plans) |
private insurers like HMOs and PPOs provide Part A, Part B, and, sometimes, Part D coverage to people who enroll.
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| Part D (Michigan Medicare prescription drug coverage) |
helps cover prescription drug costs. |
Types of coverage that are NOT Michigan Medigap policies
- Michigan Medicare Advantage Plans (Part C), like an HMO, PPO, or Medicare Private Fee-for-Service Plans
- Michigan Medicare Prescription Drug Plans (Part D)
- Medicaid
- Employer or union plans, including Federal Employees Health Benefits Program (FEHBP)
- TRICARE
- Veteran's benefits
- Long-term care Insurance policies
- Indian Health Service, Tribal and Urban plans
What do I need to know if I want to buy a Michigan Medigap policy?
When you buy a Michigan Medigap policy, in most cases you will need to already be enrolled in Medicare Part A and Part B. Therefore, you will have to continue to pay the monthly Medicare Part B premium. You will also have to pay a premium to the Medigap insurance company. You can buy a Medigap policy from any insurance company that is licensed in Michigan to help you
enrol.
All new Michigan Medigap policies are guaranteed renewable. This means the insurance company cannot cancel your Medigap policy as long as you pay your premiums. Although some Medigap policies sold in the past covered prescription drugs, no new Medigap policies are allowed to include prescription drug coverage. If you want prescription drug coverage, you may want to join a Medicare Prescription Drug Plan known as Part D, which is offered by private companies approved by Medicare.
When is the best time to buy a Michigan Medigap policy?
The best time to buy a Michigan Medigap policy is during your Medigap open enrollment period. This period lasts for 6 months and begins on the first day of the month in which you are both age 65 or older and enrolled in Medicare Part B. During this period, an insurance company can’t use medical underwriting. This means it can’t refuse to sell you any Medigap policy it sells, make you wait for coverage to start, or charge you more for a Medigap policy because of your health problems.
While the insurance company can’t make you wait for your coverage to start, it may be able to make you wait for coverage of a pre-existing condition. A pre-existing condition is a health problem you have before the date a new insurance policy starts. In some cases, the Medigap insurance company can refuse to cover your out-of-pocket costs for health problems for up to 6 months. This is called a "pre-existing condition waiting period."
If you have a pre-existing condition, and you buy a Michigan Medigap policy during your Medigap open
enrolment period and if you recently had creditable health coverage, the insurance company must shorten or eliminate this waiting period.
There are many types of Michigan health care coverage that may count as creditable coverage for Medigap policies, but they will only count if you didn’t have a break in coverage. A break in coverage means you are without any creditable health coverage for more than 63 days in a row.
Why is it important to buy a Medigap policy when I am first eligible?
It is important to understand your Medigap open enrollment period. During your Medigap open
enrolment period you can buy any Medigap policy the company sells. If you apply for coverage outside of your Medigap open
enrolment period, there is no guarantee that an insurance company will sell you a Medigap policy unless you are eligible for other reasons, and even then your choices will most likely be limited. Also, after your Medigap open
enrolment period ends, Medigap insurance companies are allowed to use medical underwriting to decide whether to accept your application and how much to charge you for the Medigap policy.
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