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There are certain health related expenses that Original Medicare does not cover, such as copays, coinsurance, deductibles, and other out-of-pocket costs. But Medicare beneficiaries in Pennsylvania have the option of enrolling in a Medicare Supplement plan (also known as Medigap or MedSup) to help cover those out-of-pocket expenses.
In most states, including Pennsylvania, there are ten standardized Medigap plans, each labeled with a letter. All plans with the same letter provide the same coverage, no matter which insurer provides the plan.
The best time to enroll is during the six-month Medigap Open Enrollment Period (OEP). The OEP begins on the first day of the month that a beneficiary is age 65 or older and enrolled in Medicare Part B. During the OEP, a beneficiary has the guaranteed issue right to enroll in a plan of their choosing without undergoing medical underwriting, and insurers cannot charge more, or deny coverage completely during this period. Note: Even during this six-month period, insurers may have the ability to impose a waiting period for pre-existing conditions*.
After the OEP has expired, a Medicare beneficiary can still enroll in a Medicare Supplement insurance plan in Pennsylvania, but may be required to submit to a medical underwriting check which could result in higher premiums or denial of coverage.
As mentioned, Medicare Supplement insurance plans in Pennsylvania do not vary in coverage or benefits between plans of the same letter. However, the costs may vary since each independent insurer may choose their own pricing structure. Thus, it is important for Medicare beneficiaries to determine what plans are available in their state and county, and make a selection based on health needs and budget suitability.
*Pre-existing conditions are generally health conditions that existed before the start of a policy. They may limit coverage, be excluded from coverage, or even prevent you from being approved for a policy; however, the exact definition and relevant limitations or exclusions of coverage will vary with each plan, so check a specific plan’s official plan documents to understand how that plan handles pre-existing conditions.
eHealth's Medicare website is operated by eHealthInsurance Services, Inc., a licensed health insurance agency doing business as eHealth. The purpose of this site is the solicitation of insurance. Contact may be made by an insurance agent/producer or insurance company. eHealth and Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. We offer plans from a number of insurance companies.