What is a Medicare SELECT Plan?

Are you a new Medicare Recipient and looking for a way to pay for the coverage gaps in Medicare Parts A and B? Medicare SELECT is supplement coverage that pays for many of the coverage gaps left by Original Medicare by directing Medicare Recipients to specific hospitals and providers. Curious if Medicare Select is right for you? Read on to learn more.

What is a Medicare SELECT Plan?

Medicare SELECT provides supplemental coverage for original Medicare but with more limitations and restrictions than a Medigap plan. Medicare SELECT plans are available at the discretion of individual insurance carriers and cover only certain doctors and hospitals in a limited network.

Medicare offers health insurance to seniors (age 65) and people with qualifying disabilities. 

Medicare consists of multiple parts, outlined below.

• Medicare Part A and Medicare Part B, or “original” Medicare, cover basic hospitalization and routine outpatient medical care.
• Medicare Part C, also known as Medicare Advantage, offers additional coverage, including dental and vision benefits. 
• Medicare Part D covers prescription drugs for recipients of original Medicare. 

A traditional Medicare supplement plan (Medigap) covers the costs of some expenses like copays, coinsurance, and deductibles not included in original Medicare. Medicare SELECT provides similar but more limited coverage for Medicare A and B recipients. 

How Do Medicare Select Plans Differ From Other Medicare Supplements?

Medicare SELECT and supplement plans are similar but with some key differences. Medicare SELECT is a less common version of Medigap offered by only some carriers in certain areas. SELECT coverage suits enrollees who do not travel and are satisfied with the healthcare providers included in their limited network.

Medicare recipients seeking supplemental benefits in a broader nationwide network might consider a more comprehensive Medigap plan. Traditional Medicare supplemental coverage includes a larger pool of in-network providers, better suited to travelers than Medicare SELECT.  

Candidates should also consider the financial benefits of Medicare SELECT vs. Medigap. Enrollees should ensure the cost savings of choosing a SELECT plan outweigh the limitations of coverage. While these plans bridge the gaps between Medicare parts A and B, candidates must enroll in Medicare Advantage to get extended benefits like dental and vision.

What’s the Difference Between Medicare SELECT and Medicare Advantage?

Medicare Advantage plans (Medicare Part C) are offered privately by insurance carriers to provide extended coverage to Medicare parts A and B. Enrollees in original Medicare can purchase an Advantage plan to potentially add benefits not included in their basic care.

• Medicare Advantage is widely available through private insurance carriers.
• Candidates must be enrolled in original Medicare and can purchase an Advantage plan separately.
• Medicare Advantage covers extended benefits like dental, hearing, and vision.
• Advantage also includes Part D prescription drug coverage.

Medicare SELECT supplements the basic hospital and medical care provided by Medicare Part A and Medicare Part B. SELECT enrollees enjoy financial support for some costs not covered by basic Medicare including copays, coinsurance, and deductibles.

• Medicare SELECT is offered privately through certain independent insurance carriers.
• Candidates must be enrolled in original Medicare to qualify to purchase a SELECT plan.
• Medicare SELECT provides some additional financial coverage for routine hospital and medical services provided by original Medicare.
• SELECT does not offer additional healthcare benefits.
• Recipients can only use certain hospitals and healthcare providers. 

How Do Medicare Select Plans Differ From Other Medicare Supplements?

Medicare enrollees can choose from a variety of Medigap plans. Multiple plans exist, each represented by a different letter and offering different benefits. Medicare Part G and Medicare Part F, for pre-2020 enrollees, are among the most popular for their broad coverage. Generally, Medicare supplement plans with broader coverage cost more than minimal coverage plans.

Insurance companies offer Medigap plans largely based on the coverage each plan provides. Plans supplement the benefits covered in Medicare parts A and B in varying percentages. For example, some plans cover 100% of hospice care, nursing home coinsurance, and blood draws up to three pints, while others cover only 50%-75% of costs or do not offer any coverage. 

Carriers commonly offer SELECT versions of lettered Medicare supplement plans, such as Medicare Part G Select. These SELECT plans typically offer the same benefits as their Medigap counterparts, except they do not cover a national network of providers.

Does Medicare SELECT Cover Me While I’m Traveling?

Medicare parts A and B offer standardized healthcare coverage across the United States. While more comprehensive Medigap plans may cover emergency and non-emergency care to varying degrees in all 50 states, Medicare SELECT plans are limited to specific coverage areas. 

Medicare SELECT covers a percentage of the costs of out-of-network emergency care inside the United States. SELECT policyholders generally do not receive benefits for out-of-network non-emergency care. SELECT plans only cover international travelers (outside the U.S.) in an emergency and then only up to that plan’s limit of liability.

Should I Get a Medicare SELECT plan?

Some seniors are perfect candidates for a Medicare SELECT plan, while others may be better suited to full Medigap or Advantage coverage. First, those interested in Medicare SELECT plans should make sure carriers offer this limited coverage in their area. Since Medicare SELECT is largely based on geographical availability, it is not an option for everyone.

People who need coverage outside the scope of original Medicare, such as dental, vision, and/or prescription drug benefits, should pursue a Medicare Advantage plan. Alternatively, those who prefer the low premiums of supplemental Medicare insurance but feel boxed in by SELECT might consider a traditional Medigap plan instead.

How Do I Enroll in Medicare Select?

Seniors can enroll in Medicare up to three months before or after their 65th birthday, so the initial enrollment period for Medicare parts A and B differs for everyone. New Medicare enrollees should receive their ID card and notification of their Part B effective date, after which they can apply for a SELECT plan.

New Medicare recipients enjoy a six-month open enrollment period for Medigap or SELECT coverage, beginning the day their Part B coverage goes into effect. This open enrollment period is the only time new recipients can apply for supplemental coverage with no questions asked, including regarding any pre-existing conditions. 

At the end of this open enrollment period, candidates must undergo medical underwriting and submit to further medical questioning to apply for a Medicare SELECT plan, but they may do so at any time. Once enrolled in Medicare SELECT, recipients can only make changes during Medicare’s annual open enrollment period.