What is Medicare SELECT?
Many of those enrolled in Original Medicare cover their out-of-pocket costs by purchasing a Medicare Supplement (Medigap) plan. If a beneficiary is on a fixed income and this is not an affordable option for them, don’t give up. A Medicare SELECT plan may be just what they are looking for.
A Medicare SELECT plan is essentially a less expensive twist on a traditional Medicare Supplement or Medigap plan. To review, most states offer 10 standardized Medicare Supplement plans (Massachusetts, Minnesota, and Wisconsin work a little differently). Medicare Supplements pair with Original Medicare to assist with the “gaps” in coverage. These plans help with the deductibles and copay cost that are normally paid out-of-pocket. Each plan has individual coverage benefits and premium costs vary to reflect this.
What Makes Medicare SELECT Different?
If Medicare SELECT plans are essentially Medigap plans, how can they cost less? The downside to their lower premiums is that for a beneficiary’s plan to cover them, they must receive treatment within the plan’s provider network. They essentially operate in the manner of an HMO, which means they may also need to get a referral from their primary care physician before they see a specialist or visit the hospital in network. The one exception to this is in the case of an emergency.
What’s the Benefit?
Since the plan can negotiate prices with the health care providers in the network, Medicare SELECT plans often have less expensive premiums than traditional Medigap. This can make a SELECT plan extremely attainable for a senior that’s living on a budget.
However, because Medicare SELECT plans focus on specific areas, they are not offered everywhere. It’s very possible that the Medicare Supplement insurance companies in a beneficiary’s area do not offer Medicare SELECT plans.
If a beneficiary is looking at Medicare plans, a Medicare SELECT plan is worth checking out. The most important step is to consider the network. If they want to keep their current primary care physician, it’s especially important to see that they are included as a covered health care provider in that plan’s network. One advantage of a Medicare SELECT plan is that a beneficiary can try it for 12 months and switch back if they do not like it. At any point within that period, they can disenroll. They can then enroll in a standard Medigap plan.
All told, a Medicare SELECT plan is not for everyone, but can help many seniors find affordable coverage to bolster Original Medicare. If there’s a Medicare SELECT plan near a beneficiary that has a suitable network, this may be a great option that may save them money while offering the same quality coverage they have come to expect.
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