Pennsylvania Medigap plans are plans that fill in the “gaps” in Medicare Parts A and B. These plans are sold by private insurance companies and follow the Medigap standardized plans chart. That is, all companies are have to offer plans that fit one of the ten standardized plans (A-N). This insures standardization of plan coverage. In other words, a Plan F with one company is the same as a Plan F with another company.
The Pennsylvania plans are the same, coverage-wise, as the nationally-standardized plans, but there are some unique aspects that make it important to understand state-by-state differences.
First of all, there different companies that offer plans in each state. In PA, there are 30+ companies that currently offer PA Medigap plans. These companies range from national Medigap companies, such as Mutual of Omaha, AARP (United Healthcare), CIGNA and Aetna, to more regional or state-specific companies, like Highmark and Capital BCBS. Although coverage is standardized, rates can vary considerably from one company to another.
In addition to coverage being standardized, claim payments (Medicare “crossover” system) and doctor acceptance (Medigap plans don’t have networks – you can go anywhere that takes Medicare nationwide) are also standardized on Medigap plans. This make comparing the rates and company reputation the two variables that matter. Currently, the companies that have the most competitive PA Medigap rates are Mutual of Omaha, CIGNA, Stonebridge, Aetna and Medico. To get a Pennsylvania Medigap quotes by email, you can go here.
Another important aspect of PA Medigap rates is how the rates are set. Rates are determined by your age, gender, and zip code. In PA, most companies have 2-3 geographic rate areas. In most cases, urban areas have higher Medigap rates.
Two other aspects of Medigap coverage that are state-specific and important to know are the under-65 Medigap availability and the tobacco use open enrollment guidelines. First of all, in PA, Medigap plans ARE available to those under age 65 if you apply during your six-month open enrollment window that coincides with the start of your Medicare Part B. This is not the case in all states, but this is the case in PA. Also, during open enrollment (whether under 65 or over 65), tobacco rates do not apply during your open enrollment period.
Applying for a Medigap plan during your six-month open enrollment window is the best way to insure that you can get the plan you want at the price you want. Outside of that initial open enrollment period, you would have to “qualify” medically to get a plan and may be denied coverage or made to pay more. There is not an annual enrollment period, contrary to popular misconception – this only applies to Part D and Medicare replacement plans called Medicare Advantage.
If you have any questions about Pennsylvania Medigap plans or want to get a PA Medigap comparison, you can contact us online or call us at 877.506.3378.