What is the Best Medicare Supplement for Autoimmune Conditions?
As you age, you’re thinking more and more about your healthcare and how you’re going to protect yourself for the rest of your life. Though you’re perfectly healthy now, you don’t know if you will be in two, five, 10, or even 20 years from now. You want to be reassured that once you hit 65 and beyond, you’re going to be covered for healthcare expenses, and not have to worry about saving up thousands of dollars for any issues that may arise.
One of the health issues that has you worried is an autoimmune disease. You’ve heard of people that have them, and you know these types of diseases can be costly, or even deadly if they go untreated. You want to be empowered with the knowledge of what an autoimmune disease is and how you can sufficiently treat it just in case you are also diagnosed with one.
When you get to age 65, you know you’re going to automatically be enrolled in Original Medicare, which is also called Medicare Part A and B. You know that is covers things like part-time skilled nursing care, diagnostic testing, and at-home physical therapy, registered nurses, and licensed practice nurses. You’re also aware that it will cover 100 days in a nursing home following a stay in a hospital, as well as end-of-life care in the last six months from hospice, nurses, doctors, prescription drugs, counseling, personal care, and homemaker services.
Unfortunately, Original Medicare may not cover all services for people with autoimmune diseases. Let’s first examine what an autoimmune disease is, and then dive into what is a Medicare supplement to see if it’s the best option for you.
WHAT IS AN AUTOIMMUNE CONDITION?
An autoimmune condition occurs when someone’s immune system attacks his or her body. The immune system, when it’s functioning properly, will safeguard itself against bacteria and viruses, and when it believes these invaders are present, the cells will attack to protect the body. It knows which cells are supposed to be there and which ones are foreign. When someone has an autoimmune condition, the immune system believes that skin or joints or other parts of the body are actually foreign. It will then release autoantibodies, which are proteins, and then attack the healthy cells. While some autoimmune diseases will attack one organ, others may attack the whole body.
There are over 80 different types of autoimmune diseases out there. Women are far more likely to get autoimmune diseases. They have a 2:1 rate compared to men. Autoimmune diseases can be carried on through genetics. Some types of diseases are more common in different ethnic groups; lupus is more common among Hispanics and African-Americans than Caucasians.
The most common autoimmune diseases are type 1 diabetes, psoriasis, Rheumatoid arthritis, multiple sclerosis, lupus, Addison’s disease, Graves’ disease, inflammatory bowel disease, pernicious anemia, and celiac disease. Though these are different diseases, they have similar symptoms early on, which include fatigue, hair loss, skin rashes, achy muscles, trouble concentrating, low-grade fever, numbness and tingling in feet and hands, and swelling and redness.
To find out if you have an autoimmune disease, your doctor will put you through a series of tests. One of them is an antinuclear antibody test, which, if it comes up positive, means you may have one of the diseases. If you have an autoimmune disease, it can be costly to treat, and you’re going to need to go to a specialist, most likely. For instance, gastroenterologists will help you with celiac and Crohn’s disease, while a dermatologist will treat you for psoriasis and other skin conditions.
The doctor may put you on prescription drugs, instruct you to get regular exercise and eat healthier, and give you nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen, as well as immune-suppressing drugs.
Now that you know all about autoimmune conditions, let’s look at what Medicare Supplement insurance is and how it can help you in case you are diagnosed.
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WHAT IS MEDICARE SUPPLEMENT?
Medicare Supplement, which is also known as Medigap, is a policy that will cover costs that Original Medicare may not, such as copayments, coinsurance, and deductibles. If you’re looking into Medicare Supplement insurance, you will find that private companies sell it, and it may cover your healthcare when you travel outside of the U.S.
If you want to purchase a Medicare Supplement plan, you must already be enrolled in Medicare Part A and B. You will pay the private Medicare Supplement provider a monthly premium, which is going to be in addition to the monthly premium you pay Original Medicare for Part B. If you and your spouse want Medicare Supplement, you will have to pay for your own separate policies. You also have to purchase a plan for where you live. If you pay your premium every month, you cannot have your Medigap policy cancelled, even if you discover that you have a new condition, like an autoimmune disease.
While Medicare doesn’t cover prescription drug coverage, only a Medicare Prescription Drug Plan, Part D, is going to cover it. You cannot have a Medicare Advantage Plan and a Medigap plan at the same time. A Medicare Supplement plan is not going cover long-term care, hearing aids, eyeglasses, private-duty nursing, or vision or dental care. There are no referrals to see a specialist and you can go to any doctor that takes Medicare patients.
If you’re wondering the more specific details about what Medicare Supplement insurance is, then take note that there are 10 different plans. Usually, these plans are the same in every state, but you’ll need to double check that when you make your purchase. The plans are A, B, C, D, F, G, K, L, M, and N.
The plans cover different things. For example:
- Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used): All the plans cover this 100%
- Blood (first 3 pints) is covered by every plan except for K (50%) and L (75%)
- Skilled nursing facility care coinsurance is not covered by A and B, is 50% covered by K, 75% covered by L and 100% covered by the rest
- Part A hospice care coinsurance or copayment is covered 100% by all except K (50%), and L (75%)
- Part A deductible is covered by all except A (none), K (50%), and L (75%)
- Part B excess charge is only covered fully by F and G
Now that you know what Medicare Supplement insurance is, you can determine which one is the best for an autoimmune condition.
THE BEST MEDICARE SUPPLEMENT FOR AN AUTOIMMUNE CONDITION
When looking at Medicare Supplement insurance plans, and which one is the best, you’ll find that F is, because it provides the most comprehensive benefits. Before signing up for Plan F, you need to know that it is going away on January 1, 2020. If you already signed up for it, or you can make that deadline, you’ll be able to keep your coverage.
Plan F is the most popular Medicare Supplement plan. Its benefits include:
- Medicare Part A coinsurance and hospital costs
- Medicare Part B coinsurance of copayment
- Part A hospice care coinsurance or copayment
- Skilled nursing facility coinsurance
- Medicare Part A deductible
- Medicare Part B deductible
- Medicare Part B excess charges
- Foreign travel emergency (up to plan limits)
- Blood (first three pints)
If you have an autoimmune condition, you’re going to need the most coverage you can receive. If you aren’t going to make the January 1, 2020, deadline, you can look into Medigap policy Plan G instead. It is not as comprehensive as F, but it can offer you lower healthcare costs going forward, especially as you’re dealing with expensive treatment for an autoimmune disease.
FINDING A MEDICARE SUPPLEMENT PLAN
You now know the answer to “What is Medicare supplement insurance?” as well as the details on the different autoimmune diseases. Even if you are perfectly healthy now, you want to be protected as you get older and your healthcare costs increase.
That’s why it’s important to start looking for a Medigap policy that will work for you. To do this, simply use Ensurem’s Medicare Supplement Quote tool, which will give you the best policy for you in a few minutes. Simply log onto the website, enter a little bit of basic information like your birthday, gender, tobacco use, and location, and you can choose from various plans. Remember to sign up as close to your 65th birthday as possible so you’re covered for any and all circumstances going forward in life.
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Denise Austin, 65, Ensurem Ambassador
Best-Selling Author, Creator of Fit Over 50 Magazine
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