Last Updated on
October 6, 2016
As a Medicare beneficiary in Delaware, you may have several Medicare Supplement (or Medigap) plan options, depending on the zip code in which you live. Understand what each Medigap insurance plan covers, and get help selecting the one that works best for your health and budget needs.
Medicare Supplement (Medigap) plans in Delaware are may help cover health-care costs associated with Original Medicare, Part A and Part B, such as copayments, coinsurance, deductibles, and other out-pocket expenses. There are 10 standardized plans, each labeled by one of 10 letters (A, B, C, D, F, G, K, L, M, and N), and a plan with the same letter name offers the same benefits. The same 10 plans are available in 47 states, including Delaware. Three states – Massachusetts, Minnesota, and Wisconsin – offer different Medigap plans. Also, please note that some companies may offer additional innovative benefits.
To be eligible for Medigap in Delaware, you must already be enrolled in Original Medicare, Part A and Part B. Your Medigap Open Enrollment Period is generally the best time to join a Medigap plan This period starts the first day you are both age 65 or older and enrolled in Medicare Part B, and it lasts for six months. During this time, you can sign up for any Medicare Supplement plan available in your area, with the insurance company of your choosing, and not be subject to medical underwriting or any restrictions for pre-existing conditions (although waiting periods may apply). Basically, this means that an insurance company can neither deny you nor charge you more for a Medigap plan in Delaware. If you apply for a Medigap policy outside of this period, you may be denied coverage or charged more for the insurance policy.
Remember that even if you sign up for a Medicare Supplement plan, you must remain enrolled in Original Medicare, Part A and Part B, and go on paying your Medicare Part B premium, to keep your health insurance coverage. Since Medigap plans are meant to supplement and not replace Original Medicare, failure to pay your Medicare Part B premium may result in your being disenrolled from Medicare and losing your health coverage.
Also note that Medigap plans sold today in Delaware (or in any other state) do not offer prescription drug coverage, so you may want to enroll in a stand-alone Medicare Part D Prescription Drug Plan if you want to receive coverage for prescription drug expenses. Medicare Part D Prescription Drug Plans in Delaware and the rest of the United States are available through private insurance companies that contract with Medicare.
Familiarize yourself with the 10 standardized Medigap plans available in Delaware so that you can select the one that may suit your needs. Here’s a quick look at what each plan has to offer. In this chart, X indicates that the service (or item) is 100% covered; a percentage indicates what percent of the service/item is covered; and a blank cell indicates it is not covered. Please note that not every Medigap plan may be available in your part of Delaware.
|Medicare Supplement Plans|
|Medicare Supplement Benefits||A||B||C||D||F*||G||K||L||M||N|
|Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted||X||X||X||X||X||X||X||X||X||X|
|Medicare Part B copayment or coinsurance||X||X||X||X||X||X||50%||75%||X||X***|
|First three pints of blood||X||X||X||X||X||X||50%||75%||X||X|
|Medicare Part A hospice care coinsurance or copayment||X||X||X||X||X||X||50%||75%||X||X|
|Skilled nursing facility care coinsurance||X||X||X||X||50%||75%||X||X|
|Medicare Part A deductible||X||X||X||X||X||50%||75%||50%||X|
|Medicare Part B deductible||X||X|
|Medicare Part B excess charges||X||X|
|Foreign travel emergency coverage (up to plan limits)||80%||80%||80%||80%||80%||80%|
|Out-of-pocket limits apply.**|
*Medicare Supplement Plan F offers a high-deductible version in which beneficiaries pay a certain deductible amount before the plan begins coverage. This amount may change from year to year.
**Once you reach the out-of-pocket limits (including the Part B deductible), both Medicare Supplement Plans K and L pay 100% of covered services in the above chart for the remainder of the calendar year.
***Medicare Supplement Plan N pays 100% of the Medicare Part B coinsurance, except for a copayment of up to $20 on doctor visits and up to $50 on emergency room visits that don’t result in an inpatient admission.
Medicare Supplement plans in Delaware with the same letter designation don’t vary in coverage or benefits, as explained earlier. However, each independent insurance company offering Medicare Supplement plans can determine its own monthly premium structure. This means that if you live in Wilmington, in New Castle County, you may pay more or less than a resident of Dover in Kent County for an identical Medicare Supplement plan. Knowing the difference in costs, it may be a good idea to compare all Medicare Supplement plans available in your area, and then choose a Medigap plan in Delaware based on your individual budget and health needs.
Access the following resources to get more information about Medicare insurance in Delaware:
Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.