Ahmijoy Asked May 2018
Healthcare marketplace for supplemental insurance?
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I was wondering if anyone might know if I can get supplemental insurance on the Healthcare Marketplace? If I can, do I still get a subsidy? Both hubby and I will be on Medicare next year. I’m on the fence about getting supplemental at all since I’m on no meds, but Hubby definitely needs it with his issues. I never considered using the HCM. Thanks in advance for your help!
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We qualified for a lower income subsidy through a grant (I don't remember all the details now). For years my monthly premium was about $183; my father's was less than $125. The grant expired, my premium became a bit less than $185; Dad's shot up to almost $300.
I used to wonder sometimes how worth it this extra cost was, until Dad experienced so much need for medical care, and I had an emergency appendectomy and a stroke a few years later. All the premiums we paid were more than worthwhile as I reflect on the astronomical costs of so much care for Dad over the last several years.
My hospitalizations cost would have bankrupted me.
We were never limited for treatment sources, but I had planned years ago to use doctors and services that were within the same hospital system. And there were definitely hospitals I boycotted. I never felt our options were limited.
The only out of pocket costs for were protective foot gear for me for foot injuries, support stockings, foot creams, dental (which Dad got through the VA) and eyeglasses, and similar items. I don't think any of them amount to more than a few hundred dollars for Dad and much less for me.
You wrote: "The Medicare part B monthly payment is paid directly to the supplemental insurance provider."
Unfortunately, this is one of those days when part of my brain is still recovering from the heat and is not completely functional. For the life of me, I can't figure this out. Medigap C premiums were billed directly by the provider, which also covered Part B if I remember correctly. What I do remember is never paying anything other than the Medigap premiums, and the occasional out of pocket costs.
I could go through the old statements and see how Medicare and BCBSM may have noted the Part B premiums, but we never paid anything directly for that. I do have just a vague recollection of seeing notes on the Medicare EOBs that the deductibles had been met - there might have been some notes on the Part B costs as well - I just don't remember at this point. I spent more time scrutinizing the actual costs as I had over the years found some to be false and had to follow up to get the cheaters caught.
I imagine you can go to your state’s exchange website and try to get answerss there.
As stated above I would begin to research Medicare supplement insurance plans as well. I was helping a friend who recently went on SSDI and needs to choose a supplement and we went to the Medicare.gov site, placed her zip code in the search box which then provided info on what supplemental plans were in her area.
Before you sign up for a plan carefully review the wording on what is covered. A lot of people choose a Medigap policy to cover the 20% but I have heard these plans have high deductibles & copays and limit where one can go for treatment. The Medicare part B monthly payment is paid directly to the supplemental insurance provider.
I can be wrong though and will be curious to read the answers here. It’s complicated!
Good luck! Kudos for thinking ahead.
This is a major project; spend some time doing research. I used spreadsheets to compare plans when I was first shopping.
If helps to factor out the most important considerations, the needs that need to be consistently and more frequently addressed, then compare plans to see which offers the best for those high priority needs.