What You Need to Know
Medicare Supplement plans in Vermont can help cover out-of-pocket expenses not covered by Medicare.
You’ll need a separate Medicare Part D plan for prescription drug coverage.
Medicare helps pay for medical expenses like hospital stays or doctor visits, but it doesn’t cover all of your healthcare expenses. Original Medicare, or Medicare Part A and B, has out-of-pocket costs like deductibles and copayments.
Medicare Supplement Insurance plans in Vermont, also called Medigap policies, are additional insurance offered by private insurance companies. These plans help cover out-of-pocket costs related to Original Medicare.
When Can You Enroll in Medigap?
- Medigap Open Enrollment Period (OEP): The best time to buy a Medigap policy in Vermont is the six months after you turn 65 and enroll in Medicare Part B. Insurance companies can’t charge you more or deny your application because of your health. That means you’ll likely get the most coverage options and lowest costs, even if you have preexisting conditions like cancer or diabetes.1
- Outside Open Enrollment Period: You’re still eligible to buy a Medicare Supplement plan in Vermont outside of your OEP. However, you’ll likely need to go through medical underwriting. This lets insurance companies charge you more, reject your application or require a waiting period based on health conditions.
- Guaranteed Issue: In some cases, you can enroll in a Medigap policy outside of your OEP without medical underwriting. This is known as guaranteed issue rights. You can’t be denied coverage, charged more, or have to go through a waiting period because of your health.2
- Special Enrollment Period: Guaranteed issue rights mean you can enroll in a Medigap policy without worrying about being charged more or denied. These situations include:
When to Sign Up
The best time to sign up for a Medicare Supplement plan is during your Medigap Open Enrollment Period.
What Are the Most Popular Medicare Supplement Plans?
Over 52,000 Medicare enrollees have Medigap policies in Vermont. The most popular plans are C, F and N. Medigap Plan C has over 13,000 plan members while Medigap Plan N has over 10,000. Medigap Plan F has nearly 10,000 members enrolled.3
- Plan C: This plan covers most out-of-pocket costs of Medicare Part A, including coinsurance for hospital stays, hospice care and skilled nursing facility care. It also covers up to three pints of blood. This plan will pay for your Medicare Part A and Part B deductible. You won’t be able to join Plan C if you became eligible for Medicare after January 1, 2020.
- Plan F: This plan covers the same costs as Plan C. It also includes coverage for Medicare Part B excess charges. Like Plan C, you’re not eligible for Plan F if you became eligible for Medicare after January 1, 2020.
- Plan N: Unlike Plan F and C, you can sign up for Plan N even if you’re eligible for Medicare after January 1, 2020. This plan helps pay the Medicare Part A coinsurance and deductible. It also covers Medicare Part B copayments, but not the Part B deductible or excess charges.
How Do You Choose a Medicare Supplement Plan?
To find the Medicare Supplement plan in Vermont that’s right for you, start comparing plans before your OEP. Compare the costs for the plan you want from various private insurance companies.
Be sure to think of other potential health expenses you might face in the future. For example, if you plan to travel overseas you may want a plan that covers foreign travel emergencies.
Medigap policies are standardized by letter, so you can compare costs from different insurers.
How Much Do Medigap Policies Cost?
There are three ratings insurance companies use to price plans.4
- Community-rated: The premium is the same for everyone on the plan.
- Issue-age-rated: Your premium is based on your age when you enroll and doesn’t increase as you age.
- Attained-age-rated: Your premium goes up as you get older.
Plans in Burlington range from $42 to $728 per month. Plan N costs between $119 and $451 per month. You’ll also be responsible for the Medicare Part B premium, which is $148.50 per month for most Medicare members in 2021.5
What If You Want to Change Your Medigap Policy?
You can switch your Medigap policy at any time. Changing Medicare Supplement plans in Vermont outside of your OEP or without a guaranteed issue right usually means you’ll go through medical underwriting. You could be charged a higher rate or rejected from the new plan if you have health issues.
If you’re accepted by a new plan, you’ll need to contact your old insurance provider and request to cancel your policy.
What Are Alternatives to Medicare Supplement?
Medicare Advantage, known as Medicare Part C, is another option instead of Medigap. Medicare Advantage plans replace your Original Medicare coverage with a private insurance plan. Your MA plan is required to offer the same coverage as Original Medicare. Many plans also include a prescription drug plan and benefits like dental coverage. Most use a provider network like an HMO or PPO.
What Are Medicare Resources in Vermont?
- State Health Insurance Program (SHIP): This program provides free resources and counseling to help Medicare beneficiaries find plans and enroll in Medicare.
- Vermont Department of Financial Regulation – Insurance Division: This state department helps regulate insurance providers, investigates fraud and provides resources for consumers.
- Medicaid, or Green Mountain Care: The Medicaid program provides free or low-cost medical coverage for low-income seniors and those with certain disabilities.
If you feel a Medigap policy provides the right coverage for you, start comparing Medicare Supplement Insurance plans in Vermont before turning 65. This lets you decide on a plan so you can buy a Medigap policy as soon as you sign up for Original Medicare.