Learn How Medicare Supplement (MS) Works

Generally, you must have Original Medicare — Part A and Part B — to buy a Medicare Supplement policy. A Medicare Supplement policy only covers one person, so if you and your spouse both want Medicare Supplement coverage, you each have to buy your own policy.

If you have a Medicare Supplement policy and get care, Medicare Supplement will pay its share of the Medicare-approved amount for covered health care costs. In most Medicare Supplement policies, you agree to have the Medicare Supplement insurance company get your Part B claim information directly from Medicare Supplement. Then, your Medicare Supplement policy will pay your doctor whatever amount you owe under your policy and you’re responsible for any costs that are left. Some Medicare Supplement insurance companies also provide this service for Part A claims.

If your Medicare Supplement insurance company doesn't get your claims information directly from Medicare, ask your doctors if they "participate" in Medicare. This means that they "accept assignment" for all Medicare patients. If your doctor participates, your Medicare Supplement insurance company is required to pay your doctor directly, if you ask them to.

Once you buy a policy, you'll keep it as long as you pay your Medicare Supplement premiums. All standardized Medicare Supplement policies are automatically renewed every year, even if you have health problems. Your Medicare Supplement insurance company can only drop you if:

• You stop paying your premiums
• You weren't truthful on the Medicare Supplement policy application
• The insurance company goes bankrupt or goes out of business

Medicare Supplement & Medicare Advantage Plans

A Medicare Supplement policy is different from a Medicare Advantage Plan (Part C). A Medicare Advantage Plan is another way to get your Medicare coverage besides Original Medicare. A Medicare Supplement policy is a supplement to Original Medicare coverage. When you’re getting started with Medicare, you can either buy Medicare Supplement or enroll in a Medicare Advantage Plan, but you can’t have both.

• If you have a Medicare Advantage Plan, you can’t buy a Medicare Supplement policy. It's illegal for anyone to sell you a Medicare Supplement policy unless you're switching back to Original Medicare. If you want to switch to Original Medicare and buy a Medicare Supplement policy, contact your Medicare Advantage Plan to see if you're able to disenroll.
• If you have a Medicare Supplement policy and join a Medicare Advantage Plan for the first time, you may want to drop your Medicare Supplement policy because you’ll be paying for coverage you can’t use. If after you join a Medicare Advantage Plan for the first time and you’re not happy with your plan, you’ll have a single 12-month period (your trial right period) to get your Medicare Supplement policy back if the same insurance company still sells it once you return to Original Medicare. After that period, you might have to wait to drop your Medicare Advantage Plan, and you might not be able to buy a Medicare Supplement policy, or it may cost more.

 

What is a Medicare Cost Plan?

A Medicare Cost Plan is similar to a Medicare Advantage plan in that enrollees have access to a network of doctors and hospitals, and may have additional benefits beyond what’s provided by Original Medicare. But unlike Medicare Advantage plans, a cost plan offers policyholders the option of receiving coverage outside of the network, in which case the Medicare-covered services are paid for through Original Medicare.