Illinois Medicare Supplement Plans (Medigap)
Illinois Medicare Supplement Plans were created to work in conjunction with original Medicare to supplement it’s traditional coverage. These insurance plans were designed to provide coverage for the out-of-pocket cost associated with deductibles, copayments and coinsurance not covered by original Medicare.
Medigap is another term used for Medicare Supplement insurance. Theses plans are sold by private insurance carriers in your area. Here we will compare the different parts and plans to provide a better understanding.
Illinois Medicare Plans Outlined
- Medicare Parts A and Part B: is Original Medicare with Part A covering hospitalization and inpatient procedures. Whereas Part B covers your outpatient procedures and physician visits.
- Medicare Part C: oftentimes referred to as Medicare Advantage and is offered by private health insurance companies. This plan provides all of the same coverage as Parts A and B and may also include additional benefits such as dental, vision and prescription drug coverage. It does however, come with certain limitations.
- Medicare Part D: prescription drug coverage which is not offered with Original Medicare A and B as well as certain Advantage plans.
- Medicare Supplement Plans: supplemental insurance that picks up the remainder of what Original Medicare will not. These policies help assist with deductibles, copayments and other healthcare costs. These plans used in conjunction with Original Medicare and a Prescription Drug Plan provide the most extensive coverage.
What Medicare Covers in Illinois
As previously stated with the Traditional Medicare coverage plans, Plan A is your hospital coverage. This plan includes hospitalizations up to 60 days, nursing facility admissions and hospice care.
Medicare Part B is your medical insurance that provides coverage for physician visits, physical therapy, in home healthcare and some outpatient procedures.
Both plans only offer coverage at 80%. The remaining 20%, in addition to any out of pocket costs, are then up to the Medicare beneficiary to pay. Based on your individual healthcare needs having 1 of the 10 supplement plans will help with the these extra expenses.
Illinois Medicare Supplement Plans Requirements
To apply for Illinois Medicare Supplement Plans, you must first be age 65 and already, or soon to be enrolled, in Medicare Part B. Your Open Enrollment Period for Part B begins three months prior to your 65th birthday, the month of and three months after. If you fail to enroll in Part B during your OEP, there’s a penalty.
The penalization is a 10% increase in your monthly premium for each full 12-month period that you went without benefits. As of 2018, the monthly premium is $134.00 per month. To avoid any additional charges accrued by the late penalty fee, make sure to enroll as soon as you become eligible.
Once you’re enrolled in Medicare Part B, your Medigap Open Enrollment Period beings. It will start the first day of the month your Part B is in effect and last for six months.
Under 65 and Disabled Medicare Eligibility in Illinois
For those individuals who have been on Social Security or hold certain Railroad Retirement Benefits, after 24 months you’re automatically eligible for Medicare Part A and Part B. The Federal Medicare Program does not require insurance carriers to to offer a Supplement Plan for those disabled under 65. Some state laws however, do and Illinois is one of them. Call us for more information if you disabled and have questions about Supplemental coverage.
How to Sign Up for a Medicare Supplement Plan in Illinois
The Open Enrollment Period is the best time to sign up for a Illinois Medicare Supplement Plan. Eligibility begins on the 1st day of the month after turning 65 and having been enrolled in Medicare Part B. The next 6 months you are granted Guaranteed Issue right.
What that means is no insurance carrier can deny you a Medicare Supplement Plan regardless of any pre-existing health issues. Additionally, they cannot charge more due to said condition(s).
Additionally, in Illinois you are eligible for GI rights for two months after losing a job which had previously provided healthcare coverage.
If you sign up for a Medicare Supplement Plan at any other time outside of OE, it’s likely you’ll have to go thru medical underwriting. The insurance company can charge more for premiums and can deny coverage due to any pre-existing medical conditions if you’re enrolling outside your OE.
Illinois Medicare Supplement Plans Premiums
The various insurance companies offering Supplement Plans determines its own monthly premium. Age, sex and location is considered when calculating the cost. Premiums in Rockford will vary from those in Chicago. Additionally, insurance companies use 3 different methods when determining premium costs. These include:
- Community rated: everyone pays the same amount despite their age.
- Issue-Age rated: based on your age when the policy was purchased. The older you are the higher the premium. However, once your premium has been set, it will never increase due to you getting older.
- Attained-Age rated: premium is based on the current age when purchased and will increase as you age.
Illinois Top Medicare Supplement Plans
There are 10 letter plans to consider when choosing a Medicare Supplement Plan. Regardless of the carrier you opt for, the benefits are the same across the country. The only difference with these policies is the cost. This is determined solely by the insurance carrier itself. What one gentleman pays residing in Peoria will differ what a lady residing in Schaumburg may pay.
The top Supplement Plans in Illinois are Plans F, G and N.
Plan F in Illinois
The most sought-after of the Supplement Plans. It provides coverage for Medicare Parts A and B deductibles as well as any remaining hospital or physician’s costs not covered by Medicare. These costs include any coinsurance or copayments that fall under Part B. It also includes coverage for any foreign travel emergency. It has a high deductible version that allows for lower premium with the same benefits. This Plan has the best coverage with the least amount of out-of-pocket expenses.
Plan G in Illinois
Plan G is similar in coverage to that of Plan F. The only difference being Plan G does NOT cover your Medicare Part B deductible. As of 2018 the deductible is $183 which the beneficiary will be responsible for.
Plan N in Illinois
Plan N is similar to Plan F in coverage with the main difference being it covers 100% of the Part B coinsurance minus a small copay for some doctors and ER visits.
Illinois Medicare Advantage Plans
Medicare Advantage Plans are offered by private insurance companies with their coverage taking over for Part A and Part B. These plans are Medicare approved and come in HMO or PPO form.
While these plans have cheaper premiums, they have more restrictions and coverage limitations. It’s important to remember this when considering a Part C Plan and instead consider one of the Illinois Medicare Supplement Plans. It is likely you will save more money and receive better coverage in the long run with Supplemental insurance.
Medicare Part D is coverage for your prescription medications. Prescriptions are not covered by Original Medicare or any Illinois Medicare Supplement Plans. Regardless of whether it’s Traditional Medicare, or a supplement plan you have, it’s highly recommended you purchase a Part D plan to avoid unnecessary OOP costs associated with medications.
Like Plan B, there’s a late enrollment penalty for going without a Part D Plan. After going 63 consecutive days or more without prescription drug coverage, a penalty will be added to your monthly premium and is based on how long you went before obtaining coverage.
Compare Medicare Supplement Plan Rates in Illinois
As stated before, Illinois Medicare Supplement Plans are offered through the various private insurance carriers. While we have outlined some of the different plans, we have not touched on them all. Plan cost will vary based on the carrier and availability in your city and state.
Let us help take care of the frustration that comes along with researching the various plans and policies. We can help direct you towards the best policy to fit your individual needs. Click or call today, our agents are ready to help and our services are 100% free. You can also compare rates online here.
Illinois Medicare Resources
Each individual state in the country has has a Medicare Savings Program that provides assistance associated with Medicare costs. If you’re disabled or on a fixed income, there’s a good chance you qualify for financial assistance. These programs are designed to help those in financial need and are provided for free. Illinois’ program is IDoA and there’s a National program called State Health Insurance Assistance program, or SHIP.
Illinois Medicare FAQs:
- What diabetic medications does Illinois Medicare cover? To see what Diabetic medications and supplies are covered click here.
- What doctors accept medicare in Chicago? Most Primary Care Physicians and Specialists takes Medicare insurance. To locate a doctor in the Chicagoland area, or find out if your current provider accepts Medicare, you may use the the centers of Medicare and Medicaid physician compare link.
- Are there any Illinois Medicare changes in 2018? You can find a list of 2018 Medicare changes here.