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Ask Nancy: Can I buy a supplemental policy to my Medicare PPO?

Consumer Reports News: March 22, 2011 07:27 AM

Q. Where can I find supplemental insurance for my Medicare Advantage PPO that will cover co-pays and deductibles?

A. Sorry, such supplemental policies don't exist. The 2003 law that created the Medicare Advantage program made it illegal for insurance companies to sell policies to pick up the plans' often-considerable deductibles, co-pays, and co-insurance. If you want to buy insurance to supplement what Medicare doesn't pay, you'll have to switch back to original Medicare. Then you can buy the Medicare supplement (Medigap) plan of your choice, including several options that pick up all of the cost-sharing under Medicare Parts A and B.

You may be pleased to hear, however, that as of this year, all Medicare Advantage plans must cap annual out-of-pocket spending for medical benefits at $6,700. Previously, there was no limit on what you might have to pay out of pocket if you became seriously ill. (The out-of-pocket limits don't apply to the drug benefit in Medicare Advantage plans that offer them.)

If you want to switch back to original Medicare or to a different Medicare Advantage plan with lower cost-sharing, you can do so during the annual open enrollment period. In 2011, it will run from Oct. 15 to Dec. 7.

One caution: depending on what state you live in, you may have trouble buying a Medigap plan if you have a pre-existing condition. You can find out particulars for your state from its free Medicare counseling (SHIP) program.

--Nancy Metcalf, senior program editor

Got another question for Nancy? Ask it here.

Nancy Metcalf

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