Jane Dotson
Medicare is a health insurance program for people aged 65 and older, some disabled people under 65, and people with end-stage renal disease. It has two parts: hospital insurance (Part A) and medical insurance (Part B). In Virginia, Medicare Supplement insurance plans, also known as Medigap, are available to help pay for healthcare costs that Original Medicare doesn't cover, such as copays, coinsurance, and deductibles. These plans provide flexibility, allowing beneficiaries to see any doctor or hospital in the US that accepts Medicare patients. To sign up for Medicare Supplement insurance, individuals must already have Original Medicare Parts A and B. Additionally, Medicare beneficiaries can purchase supplemental insurance only if they also buy hospital insurance.
| Characteristics | Values |
|---|---|
| Who is eligible for Medicare? | People 65 or older, people under 65 with a disability, people with end-stage renal disease, people with ALS, and people with a kidney transplant. |
| What is Medicare Part A? | Hospital Insurance. Most people do not pay for Part A. |
| What is Medicare Part B? | Medical Insurance. Most people pay monthly for Part B. |
| What is Medicare Part D? | Coverage for prescription drugs. |
| What is the waiting period for Medicare coverage? | There is a 24-month waiting period for people receiving Social Security Disability Insurance. However, patients with kidney failure can receive Medicare without the waiting period. |
| Can I buy Supplemental Medical Insurance without buying Hospital Insurance? | No, you can only buy Supplemental Medical Insurance if you buy Hospital Insurance. |
| When can you buy Supplemental Medical Insurance? | During the initial enrollment period, during the annual general enrollment period (January 1 through March 31 of each year), or during a special enrollment period if covered under an employer group health plan. |
| Who offers Medicare Supplement Insurance in Virginia? | Anthem offers Medicare supplement insurance to individuals under 65 and eligible for Medicare due to disability. |
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What You'll Learn
Medicare Supplement Insurance eligibility in Virginia
Medicare is a health insurance program for people aged 65 or older and some disabled people under 65. Everyone eligible for Social Security Disability Insurance (SSDI) benefits is also eligible for Medicare after a 24-month qualifying period.
Medicare has two parts: hospital insurance (Part A) and medical insurance (Part B). Most people do not have to pay for Part A, but most people pay monthly for Part B. If you have Medicare Part B and you cancel it, you won't be able to get it back until January of the following year, and you may have to pay a penalty.
Medicare Supplement Insurance, also known as Medigap, is available from various private insurance companies in Virginia. These plans complement the coverage provided by Original Medicare, helping to reduce out-of-pocket expenses. For example, after Original Medicare pays its share of the approved amount for covered services, the Medicare Supplement plan pays its share of the remaining costs.
Medigap plan premiums in Virginia vary significantly, ranging from $24 for a high-deductible Plan G to $415 for the most expensive Plan D in 2024. The monthly costs for Medicare Supplement plans in Virginia can range from $56 to $188, depending on the plan chosen.
New enrollees in Virginia can choose from all available plans except Plans C or F. Those eligible for Medicare before 2020 have access to all 10 available plans.
The Initial Enrollment Period for Medicare is a seven-month period, beginning three months before an individual turns 65 and ending three months after their 65th birthday. During this time, enrolling in Medicare Part B and selecting a Medicare Supplement Plan can be done without the need for medical underwriting.
Some of the best Medicare Supplement plans in Virginia are offered by Aetna, Anthem, and UnitedHealthcare, with savings of up to 24% on Plan G policies.
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Supplemental Insurance for those under 65
Medicare is a federal program that provides health insurance for people aged 65 or older. However, younger people with certain disabilities are also eligible for Medicare. This includes people under 65 with permanent kidney failure requiring dialysis or a kidney transplant (End-Stage Renal Disease - ESRD), or Amyotrophic Lateral Sclerosis-ALS (Lou Gehrig's Disease).
In Virginia, individuals under 65 who are eligible for Medicare due to disability have the option to purchase a Medigap policy, also known as Medicare Supplement Insurance. This supplemental insurance helps fill "gaps" in Original Medicare and can pay for out-of-pocket costs that Original Medicare doesn't cover. It is important to note that Medicare Supplement plans do not typically include prescription drug, dental, vision, or hearing coverage, so individuals may need to purchase additional standalone plans for these benefits.
As per Virginia law, insurers are required to offer individuals eligible for Medicare due to disability the option to buy at least one Medigap plan. This law was amended by the General Assembly for 2024 to include End-stage Renal Disease (ESRD) as a qualifying disability. Furthermore, effective January 1, 2024, Virginia established a separate six-month open enrollment period for individuals under 65 who are Medicare-eligible due to ESRD.
It is recommended that individuals covered by traditional Medicare (Parts A and B) consider purchasing a Medigap policy or enrolling in a retiree health plan that offers Medigap coverage. This supplemental insurance is meant to supplement Medicare and not replace any part of its coverage. Additionally, individuals with Medicare Part B are encouraged to sign up for Medigap as soon as possible, as delaying enrollment may result in a penalty.
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Supplemental Insurance for those over 65
Medicare is a federal program that provides health insurance for people aged 65 and above. It also covers some disabled people under 65 and those with end-stage renal disease (permanent kidney failure requiring dialysis or a kidney transplant).
Medicare has two parts: Part A, which is hospital insurance, and Part B, which is medical insurance. Most people do not have to pay for Part A, but most people do pay a monthly premium for Part B. Those with Medicare Parts A and B can also get a Medicare Supplement plan, also known as Medigap, to pay for out-of-pocket costs that Original Medicare doesn't cover. These supplement plans do not include prescription drug, dental, and vision coverage, but standalone plans for these benefits can be purchased for an additional premium.
In Virginia, there are two ways to supplement your Medicare coverage: purchasing a Medigap policy from a private insurance company or getting Medigap coverage through a retiree health plan from your most recent employer. Medigap insurance is meant to supplement Medicare but not replace any part of it.
If you are under 65 and became eligible for Medicare Part B due to a disability, you are guaranteed the Medigap policy of your choice when you turn 65. You cannot be refused a Medigap insurance policy because of your disability or other health reasons.
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Supplemental Insurance for disabled veterans
The Department of Veterans Affairs (VA) provides benefits and services to veterans and service members, including disabled veterans. These benefits include rehabilitation and employment services, housing grants, and life insurance.
Rehabilitation and Employment Services
The VA offers rehabilitation and employment services to veterans and active-duty service members with service-connected disabilities. This program helps those who require vocational rehabilitation and offers grants to adapt homes or cars to meet disability requirements.
Housing Grants
The VA also provides housing grants to veterans with permanent and total service-connected disabilities. These grants can be used to build or remodel homes to accommodate their disability needs.
Life Insurance
The VA's life insurance program offers Service-Disabled Veterans Insurance (S-DVI), which provides low-cost coverage to eligible service members with service-connected disabilities. While the S-DVI program is no longer accepting new applications, those who already have it can keep their coverage. Additionally, the VA has introduced a new program called Veterans Affairs Life Insurance (VALife) for veterans with service-connected disabilities, with applications accepted from January 1, 2023, onwards. Supplemental coverage is available for S-DVI at an additional cost.
It is important to note that the VA does not bill Medicare or Medicaid, but they may bill Medicare supplemental health insurance for covered services. Therefore, having supplemental insurance can be beneficial for disabled veterans, ensuring they have access to a wider range of healthcare services and options beyond what is provided by the VA.
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Supplemental Insurance costs
It is important to note that these prices are for 65-year-olds, and the cost may differ for other age groups. Additionally, the cost of supplemental insurance can also depend on the level of coverage and the specific benefits included in the plan.
When considering supplemental insurance, it is essential to compare plans and companies to find the most affordable option that meets your needs. Some plans may include additional perks, such as discounts on partner products or gym memberships, which can add value to the plan.
In terms of other costs, if you have Medicare Part B and cancel it, you may have to pay a penalty to reinstate your coverage. Additionally, if you go to a non-VA care facility, you may have to pay a VA copayment for non-service-connected care. The cost of medications received during a hospital stay will also depend on the "tier" of the medication and the amount supplied, with costs ranging from $0 to $24 for a 30-day supply.
For those with low incomes and limited resources, state assistance may be available to help with the costs of supplemental insurance. Additionally, health insurance subsidies based on income can help reduce healthcare costs when purchasing an ACA health plan.
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Frequently asked questions
Medicare is a health insurance program for people aged 65 and older, some disabled people under 65, and people with end-Stage Renal Disease.
Medicare has two parts. Part A is hospital insurance, which is premium-free. Part B is medical insurance, which most people pay monthly for.
Yes, Medicare Supplement insurance (also known as Medigap) helps fill "gaps" in Original Medicare. It is sold by private insurance companies like Anthem and is available to those under 65 who are eligible for Medicare due to disability.
Medicare Supplement insurance helps cover costs that Original Medicare doesn't, including copays, coinsurance, and deductibles. It also provides flexibility to see any doctor or hospital in the US that accepts Medicare patients.
To sign up for Medicare Supplement insurance, you must already have Original Medicare Parts A and B. You can then choose from standardized plans offered by private companies, such as Anthem's Plan A or Plan F.
