Pennsylvania Medicare Supplements: What Do These Plans Cover?

Pennsylvania Medigap plans are Federally-standardized. In other words, all companies are required to offer the exact same plans. In all, there are 10 plans sold, and not all companies have to offer all plans. The majority of companies choose from a selection of 3-5 from the standardized plans chart to offer. This chart can be viewed here: Medigap coverage chart.

The plans range in their levels of coverage:Medigap Plan F, Plan G, and Plan N. Of the 10 plan options, these are the three most common. All three plans provide comprehensive coverage for the “gaps” in Medicare. Plan F is the most common and comprehensive plan – it pays everything that Medicare doesn’t cover at the doctor and hospital so that you don’t have any out of pocket costs (no co-pays, deductibles, etc). Plan G is one level below ‘F’. It pays everything that Medicare doesn’t with the exception of the Medicare Part B deductible ($140/year – in 2012). Plan N is a good option if you are in good health and want a lower-cost plan. It has a $20 doctor’s office co-pay and a $50 emergency room co-pay, as well as not covering the aforementioned Part B deductible. So you do have some minor out of pocket costs, but premiums are correspondingly lower.

Regardless of which company you purchase a Medigap plan from, it is important to have the basic understanding that your plan will work in the same way and have a couple of characteristics that apply to all Medigap plans:

  • First of all, there are no doctor/hospital networks that you must stay within. Unlike most other types of health insurance coverage, including the Medicare replacement (Advantage) plans, you will not be sent a “provider directory” to sort through because there is not one when it comes to Medigap plan. You can go to any doctor or hospital, nationwide, that accepts Medicare.
  • Secondly, you do not have to file the claims yourself or have any involvement in the claim-filing process. All companies pay claims through the Medicare “crossover” system, which insures a timely and efficient payment to the providers, without you having to be concerned about it or keep up with it yourself.

Pennsylvania Medigap Comparison

Since coverage, doctor acceptance, and claims payments are standardized across the board with all Medicare Supplement companies, the two most important things about selecting a Medigap plan are: premium and company reputation.

Comparing the price on Medigap plans should be very easy to do, and it does not require the time-consuming task of calling all of the insurance companies directly (unless you just wanted to do it that way). Regardless of who you use to sign up for a plan, it is always advisable to work with an independent agent. This does not cost you anything and allows you to compare all of the options in a centralized, unbiased place. An independent agent can also give you information about plan customer service, rate increase history, and other factors that you are not able to obtain from the companies themselves.

Medicare-Supplement.US helps you with comparing plans by providing a customized rate quote analysis that can be sent by email. This allows you to see rates and company ratings in a centralized place and will greatly assist in your understanding of the options. To have a rate quote analysis emailed to you, just request a Pennsylvania Medigap quote.

Pennsylvania State-Specific Medigap Implications

Even though the actual coverage for Medigap plans is the same in all states, including PA, there are some state-specific guidelines and factors that must be held in mind when comparing PA Medicare Supplements:

  • Pennsylvania DOES use tobacco usage as an underwriting criteria, even when you are turning 65 or in open enrollment or “guaranteed issue” period (many states do not).
  • The majority of companies that do business in Pennsylvania DO have gender-specific rates – for companies that do it this way, this just means that rates are different for males and females – in most cases, female rates are 10-15% lower. This is not required or regulated by the state, but it is a choice that many of the companies have made in regards to their plans, and nearly all employ this pricing strategy for PA plans.
  • Pennsylvania does permit household discounts to be applied on the plans, although not many companies do this. This is something to consider, if you are applying with a Medicare-eligible spouse. There are some companies (Mutual of Omaha and Family Life, to name a few) that do offer household discounts. This can definitely mean the difference in one company over another when comparing costs.
  • There are several rating areas in Pennsylvania – with most companies. This just means that your rate is determined by your zip code. Some zip codes will have higher/lower rates based on the claims that the company has received, or expects to receive, in that certain area. Generally speaking, rates can be expected to be higher in urban areas and lower in rural areas.

Obtaining a Pennsylvania Medigap Plan

Getting your Pennsylvania Medicare Supplement plan lined up is easy to do, particularly if you are in a special enrollment period, such as open enrollment (turning 65 or signing up for Medicare Part B) or “guaranteed issue” (losing employer coverage, losing Advantage plan coverage, moving to a new state, etc.)

If you are ready to sign up for a plan, simply compare the options, including rates and company ratings, select a plan and sign up. To get a rate quote comparison from us, which will include the top-priced options for your age and zip code and company ratings, simply request the information online using: Pennsylvania Medicare Supplement Quotes. We can provide the information you are seeking so you can compare multiple quotes in a centralized place and make an informed decision.

Pennsylvania Medigap: Competitively-Priced Companies Available Here

NOTE: There are obviously numerous other companies that offers plans in Pennsylvania. This is just a few of the most prominent and competitively-priced options. Contact us for information about specific companies.