Other Medicare Insurance

Medigap Plans

Medigap is Medicare supplemental health insurance sold by private insurance companies. There are 12 standardized Medigap plans (A-N) and each plan has different benefits. They help "fill the gap" and pay coinsurance, copayments, and/or deductibles for benefits that Original Medicare deems medically necessary, as well as other services not covered by Medicare.

Medigap is available to beneficiaries who have Medicare Part A and Part B. Electing Part B triggers a six-month Medigap open enrollment period, during which time coverage cannot be denied because of a pre-existing condition.

Medigap plans supplement Original Medicare only. They are not the same as Medicare Advantage plans, Medicaid, employer, or union plans, TRICARE, VA benefits, long-term care insurance policies, or Indian Health service, Tribal, or Urban plans. Medigap policies currently sold do not include prescription drug coverage. Individuals may enroll in a stand alone Medicare prescription drug plan (Part D) for this coverage.

Employer Retiree Group Plans

Employers may offer group coverage for their retired employees with Medicare. Depending on the plan, the benefits can be a combination of an active employee plan and Medicare Advantage plan or a Medicare Supplement (Medigap) plan and may offer more comprehensive benefits than Original Medicare. Plan structures vary widely and once a beneficiary leaves the plan, they may not be able to re-enroll. If you think you're eligible for retiree health benefits contact your employer or retiree benefits administrator for further information.

Signing Up for Original Medicare

Keep in mind these 3 things:

If you are already on Social Security, Medicare will sign you up and send you notification of enrollment. If you have not yet taken Social Security, and are eligible for Medicare, you must enroll on your own either online (www.ssa.gov) or by visiting your nearest Social Security office.

If you don't enroll in Part B during your initial eligibility period, you will be hit with a harsh penalty: a permanent 10 percent increase in your premium for every year you were eligible but did not elect coverage. Most people should sign up either when they turn 65 or when they stop working, whichever comes later.

There are special considerations for certain groups, however, such as federal employees. Check with your employee benefits manager to find out whether you are in such a group, then confirm this information with Medicare and Social Security. Keep notes on what information you are being given and by whom.

Hopefully we have helped you understand the basics of how Medicare works. Because Original Medicare does not cover all your costs, you may want to consider if you need other coverage to help fill those gaps. Now learn about Group Health Cooperative Clear Care® (HMO) or Group Health Options, Inc. Clear Care® (PPO) plans to see if our plans may best meet your needs.

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We offer both Medicare Advantage HMO plans and Medicare Advantage PPO plans in different areas of Washington state.
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