Beneficiaries have a great selection of Vermont Medicare plans to choose from. Insurance carriers in Vermont offer both Medicare supplement and Medicare Advantage plans. The first step is to enroll in your Original Medicare Part A and B benefits. Then you can begin to discover the various supplemental options available to you.
Vermont Medicare Basics
Residents in Vermont can enroll in Original Medicare at the local Social Security office, or they can enroll online. Your initial enrollment period for Medicare begins 3 months before your 65th birthday month and last for 7 months. Enrolling in Parts A and B during this window will insurance that you don’t have any late penalties.
Part A provides your inpatient hospital coverage as well as skilled nursing and hospice. Part B covers your medical benefits, including everything from doctor visits to surgeries. These two parts make up the foundation of your primary coverage.
Part D is optional since some people have access to drug coverage through other means, such as the VA. If you do not have other drug coverage, we recommend enrolling in a Part D plan during your initial window. Even if you don’t need prescription coverage now, you can only enroll in drug plans at certain times of year. You don’t want to risk not having coverage if you develop a health condition mid-year.
Since Original Medicare doesn’t cover everything, most individuals enroll in either a Medicare Supplement or a Medicare Advantage plan.
Vermont Medicare Supplements
Citizens of Vermont have access to ten different standardized Medicare supplement plans and one high-deductible plan. These plans have letters ranging from A – N. Medicare supplements can be used at any provider in the nation who accepts Medicare. This gives you access to over 800,000 providers.
Your doctor will bill Medicare. Medicare will pay its share of your claim and then send the rest on to your Medicare supplement company to pay.
Each Vermont Medicare supplement plan fills in a different set of gaps. Some people like the peace of mind of really full coverage like Plan F. Others prefer to seek lower premiums by agreeing to pay some copays on the back end. Let’s look at a few of the most Medicare supplements.
Vermont Medicare Supplement Plan A
Plan A has the lowest amount of coverage. Even so, this supplement will cover your coinsurance amounts both in and out of the hospital. Plan A also gives you an additional 365 days of inpatient hospital coverage after Medicare’s hospital coverage runs out. When you need outpatient medical care, Medicare covers 80% of those bills, and Plan A covers the other 20%. Some things that are not covered by Plan A are your deductibles, Part B excess charges or skilled nursing coinsurance. Nonetheless, Plan A is often one of the most affordable Vermont Medigap plans because it covers the least benefits.
Vermont Medicare Supplement Plan F
Plan F is the Medigap plans with the most benefits. Essentially, it will cover all of gaps that normally you would pay. Plan F covers both your hospital and outpatient deductibles. It covers the 20% that Part B doesn’t pay for. It even pays for your skilled nursing coinsurance and Part B excess charges. In addition, it covers up to $50K in foreign travel emergency care benefits. People on Plan F will never have to pay a copay at the doctor either.
Vermont Medicare Supplement Plan G
Plan G is the supplement with second best coverage. It functions just like Plan F except once a year you will pay your own Part B deductible. Once you pay that, Plan G covers exactly like Plan F for the rest of the calendar year. Monthly premiums are usually lower for Vermont Medigap Plan G, so it’s definitely a plan to get some quotes for.
Vermont Medicare Supplement Plan N
Plan N is a newer plan that has been around since 2010. Legislators designed this plan to offer you lower premiums in exchange for more cost-sharing for you. It’s very popular with people who don’t anticipate going to the doctor very often. You will have copays for doctor visits and emergency room care. With Plan N, you also pay your own Medicare Part B deductible and excess charges. However, state law in Vermont prohibits doctors from charging excess charges, so you won’t have to worry about this unless you seek treatment out of state.
Not everyone can afford a Vermont Medicare supplement. Fortunately there are Medicare Advantage plans in Vermont too.
Also, Vermont Medicare carriers have different rules about underwriting. If you miss your initial 6-month open enrollment window for a Vermont Medigap plan, there are some carriers who will still accept you without any health questions after the open enrollment window has ended. This is a feature that very few states have to offer.
Medicare Advantage Plans in Vermont
Medicare Advantage plans, also called Part C, are private Medicare plans that pay instead of Original Medicare. These plans often have lower premiums because you agree to pay for your services as you go along. Part C plans usually have a network of local providers. You will get your care from these providers.
Many Medicare Advantage plans in Vermont include Part D. It’s convenient to have one card that you use at the doctor’s office and at the pharmacy. It’s a good idea to put your Medicare card away in a safe plans once you enroll in a Medicare Advantage plan. Your providers will need to bill your plan instead of Medicare.
You can only enroll in Advantage plans at certain times of the year. For this reasons, be sure to check with doctors before enrolling. Some doctors don’t participate in Medicare Advantage plans.
Get Someone on Your Side with Medicare
Choosing a Vermont Medicare plan can be tricky. To evaluate all of your plan options, reach out to Boomer Benefits today. We can help you understand how each type of coverage works. We’ll also be able to provide quotes and help you see which plans your doctors participate in.