If you’re currently on, or are about to be on Medicare, and are reviewing your options for coverage, you may have come across Medicare SELECT plans. A Medicare SELECT plan is a version of one of the ten standardized Medicare Supplement (Medigap) plans. They offer the same coverage benefits, but they restrict your network. Because these plans are more restrictive, they tend to be available at a lower premium than their traditional counterparts.
How Does a Medicare SELECT Plan Work?
Much like standard Medicare Supplement plans, Medicare SELECT plans pay the remaining portion of the bill for services that Original Medicare covers. Depending on the plan that you select, this could include coinsurance, copayments, and deductibles. Because SELECT plans are versions of the standardized Medicare Supplement plans, the coverage offered is the same as its traditional counterpart. For example, Medicare Supplement Plan G and it’s SELECT option cover the same benefits, such as:
- Medicare Part A coinsurance and hospital costs
- Medicare Part B coinsurance or copayment
- Blood (first 3 pints)
- Part A hospice care coinsurance or copayment
- Skilled nursing facility care coinsurance
- Medicare Part A deductible
- Medicare Part B excess charges
- Foreign travel emergency (up to plan limits)
While the coverage is the same, if you’re considering a SELECT plan you should be aware that they do have some limitations. There are two major restrictions with SELECT plans that separate them from traditional Medigap plans.
- Network: Rather than being able to see any healthcare provider on the nationwide Medicare network, SELECT plans limit your network to specific providers in your area for non-emergency treatment. Your hospital network, and in some cases your doctor network, will be greatly narrowed. If you see a provider outside of your carriers’ network for non-emergency services, Medicare will still cover its portion, but you’ll be responsible for the out-of-pocket costs.
- Referrals: With a Medicare SELECT plan, you may be required to receive a referral from your primary care physician before seeking treatment from a specialist. Original Medicare and Medicare Supplement plans don’t require referrals.
Should I Get a Medicare SELECT plan?
Depending on your situation, a SELECT plan may be right for you. Keep in mind, not every carrier offers SELECT plans. If there isn’t a carrier in your area that offers them, you won’t be able to purchase one. You may want to consider a SELECT plan if:
- You like the healthcare providers in the carrier’s network
- You don’t travel
- You can save a significant amount of money in premiums by choosing the SELECT plan instead of its traditional counterpart
You may want to consider a traditional Medicare Supplement plan if:
- You want access to a nationwide network
- Your preferred healthcare providers aren’t in the SELECT carrier’s network
- You travel
- You won’t save very much in premiums by choosing a SELECT plan, or the savings in premiums isn’t worth the restrictions
If you choose a SELECT plan, you can enroll during the same time period that you would with a traditional Medigap plan. For instance, if you currently have a Medicare Supplement plan and would like to switch to a SELECT plan, you can apply at any time during the year. Most people prefer to sign up during their Open Enrollment Period, which starts once your Part B is effective, and lasts six months. During this time, you won’t have to answer any health questions, so applying tends to be easier.
You have many options when it comes to Medicare Supplement insurance. For some, a Medicare SELECT plan might be the best. We encourage you to weigh the benefit of less expensive premiums to the potential obstacle of a smaller network and needing referrals before you sign up. Ultimately, you should get the coverage that you feel fits your needs.
Nothing on this website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.