Delaware Medigap Plans offer a variety of options from private insurance companies, so you can select the one that best meets your budget and coverage needs. There are ten standardized policies available, labeled with letters from A to N. One thing to highlight is the inclusive rule for individuals under 65 who qualified for Medicare.
Delaware Medigap policy basics
Medigap, also known as Medicare Supplement Insurance, is a type of health insurance policy that helps cover some of the costs that Original Medicare (Parts A and B) doesn’t cover. In Delaware, private insurance companies offer Med Supp policies to Medicare beneficiaries.
Like most states, Delaware offers ten standard Medigap plans, labeled with letters from A to N. Each plan offers different levels of coverage and benefits, so it’s important to carefully review each plan before making a decision. Medigap Delaware prices are regulated so no one can offer the same plan from the same provider lower than Senior65.com.
In Delaware, as in most states, you have a six-month open enrollment period starting when you turn 65 and enroll in Medicare Part B during which you can enroll in any MedSup plan without being denied coverage due to pre-existing conditions.
On a different note, let’s talk about Excess Charges. Ever had a doctor bill that felt like a surprise attack? With certain Medigap plans—like Plan G—you’re shielded from those extra costs. Our article ‘How To Avoid Medicare Excess Charges‘ explains it all.
When should I buy a Medigap plan?
The ideal time to purchase a Medigap policy is during your Medigap open enrollment period, which lasts for six months and begins on the first day of the month when you turn 65 and enroll in Medicare Part B. During this period, insurance companies cannot use medical underwriting, which means they cannot refuse to sell you any Medigap policy they offer, charge you higher premiums based on your health status, or make you wait for coverage to begin (except for pre-existing conditions).
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What happens if you miss Medigap open enrollment in Delaware
While the insurance company can’t delay the start of your coverage, they can make you wait for coverage related to pre-existing conditions for up to six months. A pre-existing condition is a health problem you had before the new insurance policy’s start date. In some cases, Medigap companies can refuse to cover your out-of-pocket costs for pre-existing health conditions for up to six months. After this waiting period, the Medigap policy will cover the pre-existing condition. This is why it is so important that you work with a licensed independent insurance agent to help you select the right plan when you are first eligible. Feel free to call us at 800-930-7956.
Coverage for a pre-existing condition can only be excluded in a DE Medigap policy if the condition was treated or diagnosed within six months before the date the coverage starts under the Medigap policy. This is called the “look-back period.” After the six-month pre-existing waiting period, the Medigap policy will cover the condition that was previously excluded. Click here and learn what you can do if you missed the open enrollment period.
Are there other Delaware Medigap guaranteed issuance scenarios?
In Delaware, Medigap policies are guaranteed renewable, which means that the insurance company cannot cancel your policy as long as you pay your premiums on time. Additionally, Medigap policies in Delaware must be offered on a guaranteed-issue basis in certain situations:
- If you lose your health coverage under certain circumstances in Delaware, you have the right to purchase a Medigap policy (Plan A, B, D, F, G, K, or L) as long as you apply within 63 days of losing your coverage.
- Special protections apply for preexisting conditions and for the disabled. The circumstances include losing coverage due to being in a Medicare Advantage Plan that is leaving Medicare or stops giving care in your area, termination of coverage in an employer health plan, moving outside the plan’s service area, leaving a Medicare Advantage plan within one year of joining, leaving a Medigap policy to join a Medicare Advantage plan for the first time and leaving within one year of joining, leaving a plan because it failed to meet its obligations to you, or your Medigap insurance company goes bankrupt, and you lose your coverage, or your Medigap policy coverage otherwise ends through no fault of your own. The terminating plan is required to provide you with written proof of coverage as evidence of continuous insurance for enrolling in another plan.
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Medigap Options for Beneficiaries Under Age 65
Senate Bill 42 (SB 42) mandates that insurance companies offering Medigap (Medicare supplemental insurance) policies to individuals aged 65 and older must also provide the same policies to those under 65 who qualify for Medicare due to a disability. Newly enrolled Medicare recipients under the age of 65 have a six-month window to purchase one of these plans, starting from the commencement of their benefits.
It’s important to note that premium rates for pre-65 Medigap policies may differ from those for post-65 Medigap policies, and the risks assumed by insurance carriers regarding pre-65 Medigap policies may not be subsidized by purchasers of post-65 Medigap policies. SB 42 requires two separate ratings pools for pre-65 Medigap policies: one for end-stage renal disease and another for all other disabilities. Click the following link to learn more about Medigap rules for under 65.
Delaware Medigap Plan Chart of Current Plans
Plans available for those Medicare-eligible after January 1, 2020:
| Benefits | A | B | D | G* | K | L | M | N |
|---|---|---|---|---|---|---|---|---|
| Medicare Part A Deductible ($1,632) | 100% | 100% | 100% | 50% | 75% | 50% | 100% | |
| Part B Deductible ($240) | ||||||||
| Medicare Part A Hospital Coinsurance and 365 additional hospital days | 100% | 100% | 100% | 100% | 100% | 100% | 100% | 100% |
| Medicare Part B Coinsurance | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| First 3 Pints of Blood for a Transfusion | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Medicare Part A Hospice Coinsurance or Copay | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Skilled Nursing Facility Coinsurance | 100% | 100% | 50% | 75% | 100% | 100% | ||
| Medicare Part B Excess Charges | 100% | |||||||
| Foreign Emergency Healthcare | 80% | 80% | 80% | 80% | ||||
| Max Out-of-Pocket | $7,060 | $3,530 |
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*Medigap Plan G High deductible ($2,800) is also available.
Note that Plans C and F are no longer available to people who are new to Medicare on or after January 1, 2020. However, if you were eligible for Medicare before that date, but not yet enrolled, you may be able to buy them. People eligible for Medicare on or after January 1, 2020, have the right to buy Plans D and G instead of Plans C and F.
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What to do next with DE Medigap
Despite having all the crucial information regarding Delaware Medigap policies, you may still have doubts about choosing the best plan for yourself. That’s where we step in!
Feel free to drop a comment/question in the section below or directly call one of our licensed agents at 800-930-7956. We’re here to assist you in every possible way.
There is never a charge or hidden fee to work with us and no one can sell the same Medigap plan for less than Senior65.com can.