It is best to enroll in a Medigap plan during your six-month Medigap Open Enrollment Period starting the first day of the month you are 65 or older and are enrolled in Medicare Part B. During this time, you may enroll in any Medicare Supplement Insurance plan in Michigan, even if you have health problems. No medical underwriting is required, premiums are not higher based on pre-existing conditions*, and you have the guaranteed issue right to enroll in a plan of your choosing.

The expenditures from the trust funds under Parts A and B are fee for service whereas the expenditures from the trust funds under Parts C and D are capitated. In particular, it is important to understand that Medicare itself does not purchase either self- administered or professionally administered drugs. In Part D, the Part D Trust Fund helps beneficiaries purchase drug insurance. For Part B drugs, the trust funds reimburses the professional that administers the drugs and allows a mark up for that service.


The Omnibus Budget Reconciliation Act of 1989 made several changes to physician payments under Medicare. Firstly, it introduced the Medicare Fee Schedule, which took effect in 1992. Secondly, it limited the amount Medicare non-providers could balance bill Medicare beneficiaries. Thirdly, it introduced the Medicare Volume Performance Standards (MVPS) as a way to control costs.[56]
* NY: In New York, the Excess Charge is limited to 5%; PA and OH: Note: Under Pennsylvania and Ohio law, a physician may not charge or collect fees from Medicare patients which exceed the Medicare-approved Part B charge. Plans F and G pay benefits for excess charges when services are rendered in a jurisdiction not having a balance billing law; TX: In Texas, the amount cannot exceed 15% over the Medicare- approved amount or any other charge limitation established by the Medicare program or state law. Note that the limiting charge applies only to certain services and does not apply to some supplies and durable medical equipment; VT: Vermont law generally prohibits a physician from charging more than the Medicare-approved amount. However, there are exceptions and this prohibition may not apply if you receive services out of state.
The original program included Parts A and B. Part-C-like plans have existed as demonstration projects in Medicare since the early 1970s, but the Part was formalized by 1997 legislation. Part D was enacted by 2003 legislation and introduced January 1, 2006. Previously coverage for self-administered prescription drugs, if desired, was obtained by private insurance or through a public Part C plan (or by one of its predecessor demonstration plans before enactment).
Choice: Medicare Advantage plans generally limit you to the doctors and facilities within the HMO or PPO, and may or may not cover any out-of-network care. Traditional Medicare and Medigap policies cover you if you go to any doctor or facility that accepts Medicare. If you require particular specialists or hospitals, check whether they are covered by the plan you select.
MA plans often include dental, vision and health-club benefits that aren’t part of many supplements. Yet people who buy a supplement have the option of buying “stand-alone” Part D prescription drug coverage from any one of several insurers — a feature touted as one of the selling points for Cost plans, too. People in MA plans, by contrast, are limited to Part D plans sold by their MA carrier, Christenson said.

If you decide to sign up for a Medigap policy, a good time to do so is during the Medigap Open Enrollment Period, a six-month period that typically starts the month you turn 65 and have Medicare Part B. If you enroll in a Medigap plan during this period, you can’t be turned down or charged more because of any health conditions. But if you apply for a Medigap plan later on, you may be subject to medical underwriting; your acceptance into a plan isn’t guaranteed.
In 2003 Congress passed the Medicare Prescription Drug, Improvement, and Modernization Act, which President George W. Bush signed into law on December 8, 2003. Part of this legislation included filling gaps in prescription-drug coverage left by the Medicare Secondary Payer Act that was enacted in 1980. The 2003 bill strengthened the Workers' Compensation Medicare Set-Aside Program (WCMSA) that is monitored and administered by CMS.
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Keep in mind that Medigap plans don’t include prescription drug coverage (Part D), so if you want help with your medication costs, you’ll need to enroll in a stand-alone Medicare Prescription Drug Plan. In addition, you can’t use your Medicare Supplement plan to pay for costs you may have with a Medicare Advantage plan. Medigap insurance can only be used to cover costs in Original Medicare.
If you decide to stay with Medicare Advantage and just switch plans, use the Medicare Plan Finder tool or call Medicare (800-MEDICARE or 800-633-4227) to find out what other plans are available in your area and compare them. Here again, don’t just focus on low monthly premiums. Some plans advertise $0 premium policies. But focusing on low monthly costs alone is a mistake.

Humana is a Fortune 500 company offering several health insurance plans, including Medicare supplement plans. It services over 13 million customers and has won numerous awards from the National Business Group on Health, American Heart Association, Military Times and other organizations for the company’s insurance products and responsible business practices.


If you decide to stay with Medicare Advantage and just switch plans, use the Medicare Plan Finder tool or call Medicare (800-MEDICARE or 800-633-4227) to find out what other plans are available in your area and compare them. Here again, don’t just focus on low monthly premiums. Some plans advertise $0 premium policies. But focusing on low monthly costs alone is a mistake.
Health Maintenance Organization (HMO) plans: One of the most popular types of managed-care plans, this type of Medicare Advantage plan comes with a provider network that you must use to be covered by the plan (with the exception of medical emergencies). If you use non-network providers, you may have to pay the full cost for your care. You’re also required to have a primary care physician; if you need to see a specialist, you’ll need to a get a referral from your primary care doctor first.
A: In 2017, most Medicare beneficiaries can choose from a variety of plans from at least six insurance companies. The plans may have different provider networks, cover different drugs at different pharmacies, and can charge different monthly premiums, annual deductibles, and copayments or coinsurance for hospital and nursing home stays, and other services.  — Read Full Answer
The Patient Protection and Affordable Care Act ("PPACA") of 2010 made a number of changes to the Medicare program. Several provisions of the law were designed to reduce the cost of Medicare. The most substantial provisions slowed the growth rate of payments to hospitals and skilled nursing facilities under Parts A of Medicare, through a variety of methods (e.g., arbitrary percentage cuts, penalties for readmissions).

Final decisions haven’t been made on exactly which counties in Minnesota will lose Cost plans next year, the government said. But based on current figures, insurance companies expect that Cost plans are going away in 66 counties across the state including those in the Twin Cities metro. They are expected to continue in 21 counties, carriers said, plus North Dakota, South Dakota and Wisconsin.


This measure involves only Part A. The trust fund is considered insolvent when available revenue plus any existing balances will not cover 100 percent of annual projected costs. According to the latest estimate by the Medicare trustees (2018), the trust fund is expected to become insolvent in 8 years (2026), at which time available revenue will cover around 85 percent of annual projected costs for Part A services.[88] Since Medicare began, this solvency projection has ranged from two to 28 years, with an average of 11.3 years.[89] This and other projections in Medicare Trustees reports are based on what its actuaries call intermediate scenario but the reports also include worst-case and best case scenarios that are quite different (other scenarios presume Congress will change present law).
As of 2016, 11 policies are currently sold—though few are available in all states, and some are not available at all in Massachusetts, Minnesota and Wisconsin. These plans are standardized with a base and a series of riders. These are Plan A, Plan B, Plan C, Plan D, Plan F, High Deductible Plan F, Plan G, Plan K, Plan L, Plan M, and Plan N. Cost is usually the only difference between Medigap policies with the same letter sold by different insurance companies in the same state. Unlike public Part C Medicare health Plans, Medigap plans have no networks, and any provider who accepts Original Medicare must also accept Medigap.

Less expensive plans have fewer benefits and higher out-of-pocket costs. More expensive plans include extra benefits, like some Medicare deductibles, additional hospital benefits, at-home recovery, and more. You have to decide what sort of plan makes the most sense for you. If you drop your Medigap policy, there is no guarantee you will be able to get it back.
Just to make life truly confusing, the various options offered by Medigap are also sorted by letter. The choices are Plans A, B, C, D, F, G, K, L, M, and N. What these plans include is standardized by Medicare. The cost for them can vary, however, so it's worth shopping around. Joseph Graves, insurance agent and founder of “I Hate Buying Insurance,” says many people enroll in Plan F, the most expensive choice, because it covers nearly all the gaps. A person with Plan F coverage will have few or no out-of-pocket expenses, however, by the end of 2019, plan F will no longer be available to new Medicare enrollees.

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Generally, if you already receive Social Security payments, at age 65 you are automatically enrolled in Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). If you choose not to accept Part B (typically because you are still working and receiving employer insurance), you must proactively opt out of it when you receive your automatic enrollment package. You may delay Part B enrollment with no penalty under some circumstances (e.g. the employment situation noted above), or with penalty under other circumstances. If you do not receive SS when you turn 65 you must proactively join Medicare if you want it (and the penalties may apply if you choose not to based on various factors).
Most agents will know what you mean when you ask about Part F, but here’s an easier way to remember the right words. Just remind yourself that Medicare itself has Parts,  and there are only 4 of those Parts – A, B, C, and D. There’s no such thing as Part F! Many online articles will use the wrong term on purpose, because they know that consumers like you are sometimes search on the wrong term. All Supplement insurances are called Plans.   So instead of calling it Medicare Part F or Part F Coverage say Medigap Plan F. Then you’ll be right on track.
The Medigap policy you purchase must be clearly identified as “Medicare Supplement Insurance.” In most states, there are up to 10 different Medigap basic benefits options to choose from. Plans are labeled A, B, C, D, F, G, K, L, M, and N (Plans E, H, I, and J are no longer available). Plans with innovative benefits may be available and offered by a company. In Massachusetts, Minnesota and Wisconsin, Medigap policies are standardized in a different way.
The 10 different Medicare Supplement (Medigap) plans available in most states have standardized benefits across each plan letter. For example, Medigap Plan A will have the same benefits regardless of which state you live in or which insurance company you buy from. If you live in Massachusetts, Minnesota, or Wisconsin, the Medigap plans in these states are standardized differently.
How much do you know about Medicare supplement insurance? Contrary to common belief, Medicare, the government-funded healthcare insurance for American citizens age 65 and up, doesn’t cover 100% of your medical costs. Medicare supplement insurance plans add additional coverage to fill the gap in coverage between Medicare and your actual medical expenses. Private companies sell these so-called “Medigap” policies, which are typically used to cover expenses like deductibles and co-pays.
Some Medicare supplemental insurance (or "Medigap") plans cover all of an enrollee's cost-sharing, insulating them from any out-of-pocket costs and guaranteeing financial security to individuals with significant health care needs. Many policymakers believe that such plans raise the cost of Medicare by creating a perverse incentive that leads patients to seek unnecessary, costly treatments. Many argue that unnecessary treatments are a major cause of rising costs and propose that people with Medicare should feel more of the cost of their care to create incentives to seek the most efficient alternatives. Various restrictions and surcharges on Medigap coverage have appeared in recent deficit reduction proposals.[151][152][153] One of the furthest-reaching reforms proposed, which would prevent Medigap from covering any of the first $500 of coinsurance charges and limit it to covering 50 percent of all costs beyond that, could save $50 billion over 10 years.[154] But it would also increase health care costs substantially for people with costly health care needs.

Medicare2019.com is a privately owned website and is not associated, endorsed or authorized by the Center for Medicare and Medicaid Services or any other government entity. This site contains basic information about Medicare, services related to Medicare, private medicare, Medigap and services for people with Medicare. If you would like to find more information about the Government Medicare program please visit the Official US Government Site: at www.medicare.gov
Popular opinion surveys show that the public views Medicare's problems as serious, but not as urgent as other concerns. In January 2006, the Pew Research Center found 62 percent of the public said addressing Medicare's financial problems should be a high priority for the government, but that still put it behind other priorities.[91] Surveys suggest that there's no public consensus behind any specific strategy to keep the program solvent.[92]
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