Information on Medicare Supplement Plans | GenHealthy.com

Frequently Asked Questions F A Qs

Understanding Medicare Basics

Medicare is public health insurance covered by the US government. It’s for citizens age 65 or older, people under age 65 who have certain disabilities, and people of any age with end-stage renal disease.

The different parts of Medicare help cover different categories of services.

 

Part A (Hospital Insurance) helps cover:

  • Inpatient care in hospitals
  • Skilled nursing facility care
  • Hospice care
  • Home health care

Part B (Medical Insurance) helps cover:

  • Services from doctors and other health care providers
  • Outpatient care
  • Home health care
  • Durable medical equipment (like wheelchairs, walkers, etc)
  • Many preventive services (like screenings, shots, and annual check-ups)

Part D (Prescription Drug Coverage) helps cover the cost of medicines you’re prescribed. (Part D plans are run by private insurance companies that follow rules set by Medicare)

 

(Adapted from Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare, from the Centers for Medicare and Medicaid Services. Click here to view a copy)

When you first enroll in Medicare, and at certain times of year, you can choose one of two ways to get your Medicare coverage.

 

Original Medicare helps cover your Part A (Hospital Costs) + Part B (Medical Costs). There are no restrictions on what doctors you see and no need for referrals. You can buy an additional Medicare Supplement (Medigap) policy to help pay out-of-pocket costs that Original Medicare does not cover. You must also buy a separate Prescription Drug plan (Part D).

 

Medicare Advantage (Part C) also helps cover your Part A (Hospital Costs) + Part B (Medical Costs) plus Prescription Drug coverage (Part D). It can also include extra benefits like vision and hearing care. You are typically limited to staying within a network of approved doctors and to get referrals for specialist visits. If you have Medicare Advantage, you can’t buy a Medicare Supplement (Medigap) plan.

This is private health insurance that helps supplement Original Medicare. This means it helps pay some of the health care costs that Original Medicare doesn’t cover (like copayments, coinsurance, and deductibles). These are “gaps” in Medicare coverage.

 

If you have Original Medicare plus a Medicare Supplement (Medigap) policy, Medicare will pay its share of your covered health care costs. Then, your supplemental policy kicks in to pays its share on top of that. So with both plans covering you, you have no or lower out-of-pocket costs to pay on your own.

 

It’s important to note that all Medicare Supplement (Medigap) policies must follow federal and state laws designed to protect you. There are different plan types to choose from (lettered A through N) that offer different types and amounts of “gap” coverage. But all plans are standardized. So plan G from one company, for instance, has the exact same benefits as plan G from any other company.

 

(Adapted from Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare, from the Centers for Medicare and Medicaid Services. Click here to view a copy)

 

This guide from the Centers for Medicare and Medicaid Services is an excellent basic start to learning about Medicare and Medicare Supplement (Medigap) insurance. You can also learn more by visiting www.Medicare.gov 

Applying for a GenHealthy Plan

The application process takes about 10 minutes and you should receive a response via email within two business days. If you are approved for coverage, you will be prompted for your billing information and will receive a printed policy shortly thereafter.

If you are new to Medicare and have not previously enrolled in a prescription drug plan, you will want to consider doing so. Medicare Supplement plans do not include prescription drug coverage. If you are switching from another carrier’s Medicare Supplement plan to a GenHealthy policy and are enrolled in a standalone Part D prescription drug plan, you will retain this coverage and do not need to make any changes. If you are receiving drug benefits through an integrated Medicare Advantage plan, you will need to enroll in a standalone Part D prescription drug plan.

GenHealthy is designed for policyholders who are aging in good health. Because healthier people tend to experience lower medical claims, GenHealthy policyholders can typically expect to pay a lower rate than that of a comparable plan offered by a different carrier.

Your rate is subject to review and can be adjusted. Typically, rates increase with the age of a policyholder, but may also be adjusted based on changes in the claims trend of a population of policyholders. Rates cannot be adjusted for any individual policyholder without also being adjusted for all policyholders of the same policy. That means your rate can’t increase based on your personal experience alone. If your rate goes up, it also goes up by the same amount for everyone else in your area with the same plan. Rate changes must always be first approved by the state regulatory authority.

Switching From Another Plan to GenHealthy

It’s easy! For all the details on how to switch, click here to visit our How It Works page

Yes, you can switch from Medicare Advantage, but only during the Annual Election Period (which generally takes place October 15 through December 7) or during the Open Enrollment Period (from January 1 through March 31). Make sure you leave your Medicare Advantage plan when your Medicare Supplement policy begins. (See Medicare.gov for more details.)

You can enroll in the same plan type, but each person must apply for their own policy. A Medicare Supplement policy only covers one person.

No. Your GenHealthy Medicare Supplement plan covers medical care. It’s independent from your current prescription drug plan, which is known as Part D.

Every Medicare Supplement plan is covered by a 30-day free-look period that allows you to keep your current insurer if you change your mind and want to stick with them. (See Medicare.gov for more details.)

Getting Started and Using Your GenHealthy Plan

Your policy package includes your new Medicare Supplement insurance card. At your next appointment, simply provide your new card so that your billing information can be updated accordingly.

If you are currently enrolled in a standalone Part D prescription drug plan, you can keep that coverage without needing to make any changes.

If you are receiving drug benefits through an integrated Medicare Advantage plan, you will need to enroll in a standalone Part D prescription drug plan, since GenHealthy, like all Medicare Supplement plans, does not cover medications.

Don’t worry, you won’t lose your policy if your health changes. By law, as long as you pay your premium, your Medicare Supplement insurance is guaranteed renewable. That means, once you purchase a Medicare Supplement policy, it can only be canceled by your own action.

Yes – your Medicare Supplement policy follows you to any state you live in even if you relocate to a state that does not currently market GenHealthy policies to new enrollees. All premium rates are based on the state in which you originally were issued coverage.

You can talk to one of our knowledgeable customer service representatives by calling 1-855-266-8218, Monday through Friday, from 8:30 to 5:30 ET.

Within the first 30 days of purchasing your policy you are within a “free look period” and may drop your plan and may be able to return to your previous coverage without incurring any charges. After 30 days, you may drop your plan for any reason, but you may be subject to underwriting if you apply for any replacement coverage.

Top