Medicare Supplement, in plain words.
A Medicare Supplement plan is also called Medigap. Many people know it as the kind of plan where you can see any doctor who takes Medicare. It works next to Original Medicare and helps pay your share of the bills. I'm Erick Vallarino, an independent agent here in the Valley. I compare prices for you, in English or Spanish, and my help costs you nothing.
It works alongside Original Medicare.
Original Medicare is Part A and Part B. It pays a big part of your bills, but not all of it. A supplement helps with the part that's left.
You see the doctor
You go to a doctor or hospital that takes Medicare.
Medicare pays its share
Original Medicare pays its part of the covered bill first.
Your supplement helps with the rest
It helps pay some or most of your share. How much depends on the plan letter you have.
What a supplement does, and what it doesn't.
- With most policies, you can see any doctor who takes Medicare.In general, there's no network to learn. That helps if you have doctors you trust, or if you travel. Medicare SELECT policies may require certain hospitals or doctors for full benefits.
- Plans are named by letters.Each letter is a standard plan. The same letter covers the same things, no matter which company sells it. Prices can be different, so it's smart to compare.
- It does not cover your medicines.So people usually add a Part D drug plan next to it. I help you pick one that covers yours.
- Timing matters.In general, the easiest time to get a supplement is when you are 65 and first have Part B. Later, a company may ask health questions before it says yes.
Turning 65 or starting Part B soon? Read my Turning 65 page, or call me first.
Same letter, same coverage. So I shop the price.
A Plan G covers the same things no matter which company sells it. So does a Plan N, and every other letter. What changes from one company to the next is the price, and the difference can be big.
So I shop it for you. For the letter and policy type you want, I put the prices from the companies I work with side by side, and you choose. I compare standard policies separately from high-deductible policies.
Today's price is only part of the story. I also look at how each company sets its price as you get older. You can check any company's complaint record with the Texas Department of Insurance, too.
I won't push you to the most expensive plan. The insurance company pays me, not you, and I won't push you toward a pricier policy to earn more. I'm not here for one sale. I want you to keep your plan for years and tell your family and friends about me.
Want to double-check me? Medicare.gov lists the companies that sell supplements in your ZIP code.
Five things to know before you buy.
- Your best window comes once. It's the 6 months that start the first month you're 65 or older and have Part B. For example, if you're 65 and your Part B starts in April, those 6 months run from April through September. In that window, a company can't turn you down or charge you more because of your health. Some policies may delay coverage of a pre-existing condition for as long as 6 months. Qualifying prior health coverage can shorten or eliminate that wait, and some special protections prevent it. We'll check which rules apply to you.
- Outside that window, a company can ask health questions and may say no, unless you have a special right to buy one, as some people do when they lose other coverage.
- Plan F and Plan C can only be sold to people who were eligible for Medicare before January 1, 2020. If you're new to Medicare since then, Plan G and Plan D are the closest. They cover the same things, except the Part B deductible.
- One person per policy. A husband and wife each need their own. Some companies give a discount to couples, and I check that for both of you.
- It works only with Original Medicare, not with a Medicare Advantage plan. The fall enrollment period, October 15 to December 7, is for Medicare Advantage and drug plans. By itself, it doesn't give you a new chance to get a supplement without health questions.
Who it can fit, and what to ask.
A supplement can fit you if
- You want to keep your doctors, and they take Medicare.
- You travel, or you see doctors outside the Valley.
- You'd rather pay each month for the plan, so your share of each bill is smaller.
Good questions to ask
- Do my doctors take Medicare?
- Which plan letter fits how often I see the doctor?
- Which companies sell that letter, and how do their prices compare?
- Will the company ask me health questions right now?
Your supplement over the years.
Can the price go up?
Yes. Some companies raise the price as you get older. Some set it by your age when you buy. Some charge everyone the same. Any of them can also go up for other reasons, like inflation. I'll show you how each company does it.
Can the company cancel me if I get sick?
No. As long as you pay your premium, the company can't cancel your supplement because of your health.
What if I move, or spend the winter somewhere else?
In general, you keep your supplement wherever you live in the U.S., as long as you still have Original Medicare, and you can see doctors who take Medicare anywhere in the country.
I already have a supplement. Can you still help?
Yes. I'll only suggest a change if it helps you. A new company may ask health questions first. If you do switch, don't cancel your current policy until you've decided to keep the new one. You get 30 days to look over a new policy and return it for a refund.
I do the comparing. You make the choice.
I'm an independent agent. I'm not tied to one insurance company. I work with several, so I can lay your choices side by side. For Medicare Advantage, I'm contracted with Aetna Medicare, HealthSpring, Humana, Prominence Health Plan, UnitedHealthcare and Wellcare.
We look at your doctors and medicines
At your kitchen table or at an office near you. Bring your cards and your list of medicines.
I explain your choices
I go over the plan letters and the companies I work with, in plain words. If you're better off staying put, I'll tell you.
I stay your agent all year
I help you add a drug plan, too. After that, you still call me. Bills, letters, questions. You call me, not a 1‑800 number.
Does Original Medicare cover it?
- Usually covered (Part A or Part B)
- Doctor visits. Part B covers them. You usually pay a share of the cost.
- Hospital stays, when you’re admitted. That’s Part A. Being admitted is what counts, not just staying the night.
- A flu shot. Part B usually covers one each flu season.
- Not covered by Original Medicare
- Routine dental care and dentures. In most cases, Original Medicare doesn’t cover cleanings, fillings or dentures.
- Routine eyeglasses. Original Medicare helps with glasses only after cataract surgery.
- Hearing aids. Original Medicare doesn’t cover hearing aids or the exams to fit them.
- Long-term care in a nursing home. Help with daily needs like bathing and dressing isn’t covered when that’s all the care you need. A short stay for skilled care can be covered after at least 3 days admitted in the hospital.
Many Medicare Advantage plans add extras like dental, vision and hearing. A Supplement helps pay your share of what Original Medicare covers. I’ll help you compare.
Short answers.
Don't see yours? Call or text me.
Is a supplement the same as Medicare Advantage?
No. A supplement works with Original Medicare: you can see any doctor or hospital in the U.S. that takes Medicare, and the supplement helps pay your share of the bills. Medicare Advantage is another way to get your Medicare, through a private plan. Most plans include drug coverage and extras like some dental, vision and hearing care. Each plan has a yearly limit on what you pay for covered Medicare services, and most have a network of doctors. Plans with these benefits are offered in the Valley by companies I'm contracted with: Aetna Medicare, HealthSpring, Humana, Prominence Health Plan, UnitedHealthcare and Wellcare. You can't use both at once. I'll explain both. Neither one is right for everybody, so we start with your doctors and your medicines. See both side by side.
Does a supplement cover dental or vision?
In general, no. Supplement plans usually don't cover dental, vision or hearing aids. If those matter to you, there are two ways to get that coverage: most Medicare Advantage plans add extras like some dental, vision and hearing care, or a separate dental or vision policy can go next to a supplement. Tell me, and we'll look at your options before you change anything. If you drop a supplement, you may not be able to get it back later.
Does it help if I travel outside the U.S.?
Some plan letters help pay for emergency care outside the U.S., within the plan's limits, when the emergency starts in the first 60 days of a trip. Across the U.S., you can see doctors who take Medicare. We'll check the letter you're looking at.
Thinking about a supplement? Let's talk it over.
Call or text me, even with a small question. We'll look at your doctors, your medicines and your dates, with no pressure.