What are Medicare Select insurance policies? They are traditional Medicare supplement policies (like Plans F, C and N for instance) that require the use of a preferred network of doctors and hospitals for routine care.
Medicare Select Plans are sometimes popular as they are less expensive than traditional non-network driven supplemental plans. They are appropriate for those who are comfortable using a preferred network of doctors and hospitals for regular care.
Supplemental select policies work much in the same way as Health Maintenance Organizations (HMOs). The insurance company negotiates service contracts with a network of doctors and hospitals in the area where the supplement is offered – usually larger cities. These negotiations result in lower medical costs.
The cost reductions are then passed on to the consumer in the way of lower monthly premiums on their Medigap select policies. There is no additional cost sharing however. A Plan F is still a Plan F – the insured simply needs to stay in-network for his or her medical services.
It is important for the consumer to use the approved network for all routine services. If not, then the select plan may not pay its share of the bill. In some cases, referrals from a primary physician may be needed to see certain practitioners. If you travel extensively or winter in a different location, a Select Plan may not be appropriate.
Emergency services are covered out of network so long as the insurance company agrees that the situations was an emergency. Routine care will not be covered out of the approved network. Regardless of how or where medical care is needed, Medicare Parts A and B will always cover its share of approved expenses first.
The primary advantage is simply cost. By agreeing to use the approved network, consumers can save money on their Medicare supplement insurance. In some cases however, traditional supplemental plans may be less expensive than even some select plans. It is wise to shop around.
Much like Medicare Advantage plans, the primary disadvantage is simply the constraints of the network. It is important to be certain of any network limitations by first checking with the insurance company and/or the agent before purchasing a policy. And consumers must be aware that certain doctor groups and facilities may be in the approved network one year and out the next.
Consumers who move out of the approved service area will be afforded a 63 day window to purchase a new supplemental plan without the need for medical underwriting. Not all plan designations will be available during a “guaranteed issue” period such as this one, but the consumer will have certain rights to purchase new coverage.
Not all carriers offer select plans as they simply do not have the size or scope to build network driven plans. It is usually the larger companies with existing health insurance and Medicare Advantage networks who offer these types of plans, but they are somewhat rare.
A few companies worth considering if you are in the market for a Select plan will be Anthem Blue Cross and Blue Shield, AARP United Healthcare, Assured Life, Gerber Life, Mutual of Omaha and a handful of others.
By working with an independent Medicare brokerage like ours, you can compare both select and traditional Medicare supplements online. We can help you compare the direct rates for both types with several carriers.