A Medicare SELECT Supplement policy is a type of Medicare Supplement (also known as “Medigap”) policy sold in some states that requires you to use hospitals and, in some cases, doctors within its network to be eligible for full insurance benefits (except in an emergency). A Medicare SELECT Supplement policy can be any of the standardized Medicare Supplement plans identified below, but a Medicare Select Supplement Policy is only available in certain states:
How does a Medicare SELECT Supplement Policy Work?
A Medicare SELECT Supplement policy works like an Health Maintenance Organization (also known as “HMO”); however, it is not a Health Maintenance Organization. You do not surrender your Medicare benefits and you are not assigned a physician. You can keep your current physician and will not not receive a listing of Medicare SELECT participating providers. However, if you require hospitalization, your physician must have admitting privileges to the network hospital or he/she may refer you to another physician who does have admitting privileges.
What are the benefits of Medicare SELECT Supplement Policy?
A Medicare SELECT Supplement policy may offer you a less expensive premium for the same types of coverage as a Medicare Supplement policy. If you do not use an in-network facility or provider where required, your Medicare SELECT policy will not fill in the gaps in your Original Medicare coverage. However, Medicare will still pay its share of approved charges no matter what provider you use. However, in order to qualify for the lower supplement premiums, you agree to use the selected or participating hospital (or network hospitals) that has joined the effort to reduce health care cost. A plan is chosen (A through J) that best meets your needs — the same as you would with traditional Medicare Supplement polices..
How was the Medicare SELECT Supplement policy originated?
The Medicare SELECT Supplement Policy began as a government approved program in 15 states. The program was designed to help lower costs of supplement insurance for Medicare beneficiaries. Because of the success of this program, the government expanded Medicare Select to all 50 states by July of 1995.
Does a Medicare SELECT Supplement Policy Cover My Medical Expenses if I Travel?
Yes. A Medicare SELECT Supplement policy will pay 100% of all original Medicare approved charges if you are out if the area and need to be hospitalized on an emergency basis. Additionally, a Medicare SELECT Supplement policy will, in most circumstances, cover the original Medicare Part A deductible if you are admitted to a non-participating hospital on an emergency basis or if you are traveling out of the area. If you frequently travel or live close to another hospital that is not in the Medicare SELECT Supplement policy network, you should inform your insurance carrier so you can choose a Medicare SELECT Supplement policy that will cover the original Medicare Part A deductible for emergency admissions or while traveling out of the area.
Does a Medicare SELECT Supplement Policy Cover Preexisting Conditions?
Once you qualify for a Medicare SELECT Supplement policy, or apply during open enrollment or guaranteed issue, the Medicare SELECT Supplement policy works the same way a regular Medicare Supplement policy works. The preexisting conditions can be different with each carrier. Many cover preexisting conditions but it is important to check. A Medicare SELECT Supplement policy enrollment periods are the same, as a regular Medicare Supplement policy.
What if I purchase a Medicare SELECT Supplement Policy and I Am Unhappy With the Plan?
If you purchased a Medicare SELECT Supplement policy you have a “trial right”, which is also offered if you purchase a Medicare Advantage plan, which means you can switch back to original Medicare within the first year of purchasing the Medicare SELECT Supplement policy. If you elect to switch back to original Medicare and are unhappy with the plan then you can join the Medicare Supplement plan you had prior to switching to the Medicare SELECT Supplement policy, if the same insurance company you had before still sells it. If not, then you can buy a Medicare Supplement Plan A, B, C, F, K or L that is sold in your state from any insurance carrier. You can make your change in plan or policy as early as 60 calendar days before the date your coverage will end, but no later than 63 calendar days after your coverage ends. (Note: Your rights may last for an extra 12 months under certain circumstances.)
Please contact Medicare Pathways at 1-866-466-9118. A Medicare Pathways Benefit Specialist will review your situation with you and assist you in finding the most appropriate and most affordable plan to fit your Medicare insurance needs. Medicare Pathways works with over 20 companies in your area and will assist you with regard to a Medicare Supplement, Medicare Advantage or Prescription Drug Plan. You can also simply click Request a Quote and a Benefit Specialist will contact you.
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Medicare Pathways: 1-866-466-9118