Medicare Supplement Myths: Choose Your Provider and Travel, Too

Health insurance can be confusing and Medicare Supplement plans are no different. Sometimes you just need some help sifting fact from fiction to figure out what’s best for you. Below are five myths Avera Health Plans Sales Associates hear most often.

Myth 1: I can’t choose my own doctor or stay with my current doctor.

Fact: All Medicare Supplement plans allow you to choose any doctor who is Medicare-approved, and that includes both Standard and Select plans offered by Avera Health Plans. Select plans may require you to use in-network facilities for planned procedures to be eligible for full benefits (except in an emergency). It’s also important to remember that Medicare Supplement plans will always cover what Original Medicare covers, so be sure to check if your doctor is Medicare-approved.

Myth 2: I’m not covered when I travel.

Fact: Medicare Supplement plans with Avera offer emergency coverage 365 days of the year from anywhere. So if you’ll be traveling for the holidays you need not worry. If you like to travel for an extended period, perhaps during the winter months, you have options, too. For example, Avera AgilityPlus Medicare Supplement Standard plans have no restrictions on travel, and our Avera AgilityPlus Select plans will cover you for up to 90 continuous days of travel for both emergency and non-emergency care.

This means if you have a Select plan, you can’t move to Arizona for five months for cancer treatment, but if you are there for an extended vacation and get strep throat, you will be covered for a provider visit, with your 90 continuous days of coverage starting at that point. If you visit Arizona four months later and need to see a provider, you won’t be covered because the 90-day period has expired.

Myth 3: Medicare will cover all my expenses, so I don’t need supplemental insurance.

Fact: Medicare is not designed to cover everything and includes things like deductibles and coinsurance.

Plus, there is no out-of-pocket cap with Medicare. That can mean that you could pay a percentage of an unlimited amount of medical expenses over the years. A Medicare Supplement plan may play an important role and help you if you’re facing a percentage that you have to pay – these plans pick up where Medicare leaves off.

A good example is chemotherapy treatment. Some Medicare Supplement plans can cover the deductible and 20% coinsurance costs not covered by Medicare.

In addition, remember that your coverage with Avera Health Plans is more than insurance; it provides services that can help you maintain your best possible health, and that’s not something every plan offers. For example, our AgilityPlus Plan G plans offer full coverage for a Planet Heart Screening.

While a supplemental plan can offer you many benefits, it’s not the same as Medicare Advantage. That type of plan is more like traditional health insurance. You will still have out-of-pocket costs such as coinsurance, co-pays and deductibles that can use up your savings.

Medicare Supplement plans can help you avoid using savings to cover health costs.

Myth 4: My health history will affect whether I can get a supplemental policy.

Fact: Outside of your initial enrollment period for Medicare or if you qualify for a special enrollment period, most companies do ask health questions, known as underwriting. It is important to know when and how to sign up for Medicare. Speaking with a trusted local agent can help you navigate your enrollment timeframes and whether you qualify for open enrollments like Avera Health Plans’ open enrollment period. For those that qualify, we don’t ask any health questions. That means you can sign up for a plan regardless of chronic conditions or past issues such as diabetes or cancer treatment.

Myth 5: I can only change supplemental plans during certain parts of the year.

Fact: You can change Medicare Supplement plans any time of year but you will have to answer health questions or underwriting, which may limit your options. That’s why it’s so important to consider changing during an open enrollment period when Avera Health Plans is enrolling people with no health questions asked. Speaking with a local, trusted agent is a great way to understand your options and what you qualify for.

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© 2024 Avera Health Plans, All Rights Reserved. Network restrictions apply with Select plans. A Plan G policy may not cover all of your medical expenses. Neither Avera Health Plans nor its agents are connected with Medicare or state or federal government.