Get-started tips for your new Medicare Supplement plan
Here’s how your plan works, what it covers and important first steps
Are you enrolled in a Medicare Supplement plan for the first time? This plan works differently than Medicare Cost and Medicare Advantage plans that you may have had in the past. I want you to understand how it works, so here are some important tips to get you started.
Medical coverage only
You’ll have comprehensive coverage for medical care from doctors, specialists and hospitals. Your plan benefits are the same for covered services anywhere in the United States where Medicare is accepted. Supplement plans cover inpatient hospital, outpatient care, U.S. emergency and urgent care, and diagnostic tests and lab work.
Your plan doesn’t cover online doctor visits or acupuncture. You can still get these services, but you’ll pay the full cost. Review your policy to understand what services your Medicare Supplement plan covers.
One important difference between Medicare Supplement and Advantage or Cost plans is medical coverage for preventive services.
Supplement plans pay for Medicare-covered preventive screenings and immunizations. If you’ve had Part B for more than 12 months, you can also get an Annual Wellness Visit, which is a check-in each year to discuss your health with your doctor. This is not an annual physical.
Some Supplement plans cover services that Medicare doesn’t cover, like routine physical, eye or hearing exams:
- Basic plans have an option to add a “rider” that gives you $120 of preventive coverage in a calendar year for an extra monthly premium.
- Extended Basic plans include the $120 preventive benefit in the monthly premium.
- Other types of Supplement plans have no coverage for these preventive services.
No coverage for Part D outpatient prescription drugs
If you want Part D coverage, you’ll need to enroll in a separate Medicare Prescription Drug Plan. That’s important because there’s a late enrollment penalty if you don’t have Part D or similar drug coverage for more than 63 days in a row. Visit medicare.gov to learn when you can enroll in a Medicare Prescription Drug plan and to avoid this penalty.
You likely chose a Medicare Supplement plan to help fill the gaps Original Medicare doesn’t cover. Here are some ways a Supplement plan works differently than Advantage or Cost plans.
Depending on the type of Supplement plan you select:
- You may have to pay the Part A and Part B deductibles before the plan pays
- Your plan could have $0 or low copays for covered services instead of coinsurance (where you pay a percentage of the cost)
Only Supplement plans travel with you if you move to a different state. Some plans may charge a higher monthly premium if you live out of state.
How to get started using your plan
You can see any doctor who accepts Medicare. That’s right! There’s no network. Most doctors accept Medicare. Ask your doctor, or check medicare.gov to see if the provider of your choice is included.
Show your official Medicare card and your Supplement plan ID card when you get care. Carry both cards with you to make sure your medical claims get paid properly.
How do your medical claims get paid?
Medicare pays a portion of your costs first and sends you a Medicare Summary Notice (MSN) every three months. If you have questions about how much Medicare pays for covered services, call 1-800-MEDICARE.
Then the Supplement plan will pay its share of your costs. Your plan’s Explanation of Benefits will tell you how much, if anything, you owe for covered services. You can call the plan’s Member Services team if you have questions about how they paid your claim.
Renewals come later in the year
Medicare Supplement renewal information generally arrives in November. The mailing will tell you the monthly premium for the next year.
This is different than Medicare Cost, Medicare Advantage and Medicare Prescription Drug plan renewal timing. The Centers for Medicare & Medicaid Services (CMS) requires those types of plans to send you an Annual Notice of Changes by Sept. 30 every year.
It’s important to review your renewal mailing because the Medicare Annual Election Period is Oct. 15 through Dec. 7 to enroll in other types of plans. If you want to switch from a Supplement plan to something else, like Medicare Advantage, you’ll want to act by Dec. 7.
These easy tips will help you get the most from your Medicare Supplement plan. If you have more questions, call Member Services at the number on the back of your ID card.