Medicare SELECT is a type of Medicare supplemental insurance, or Medigap, that pays for some out-of-pocket costs from Original Medicare. It is only available in certain states.
Additionally, to be eligible for coverage, a person with Medicare SELECT must use the services of approved healthcare providers within a certain network.
Medicare plans have additional costs, such as coinsurances, that people are responsible for 20% of a treatment’s costs or an annual deductible the enrollee must pay before Medicare funds treatment. To help cover these costs, a person may take out a privately administered Medigap plan to pay for out-of-pocket expenses.
These include standardized plans that offer the same benefits in every state, with the only difference being the price of the monthly premium.
While Medicare SELECT plans have some restrictions on where an enrollee can receive treatment, they often charge a lower premium than other Medigap plans.
This article explains how Medicare SELECT works and some potential costs. It also answers some common questions about Medicare SELECT.
Glossary of Medicare terms
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
- Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.
- Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.
- Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.
- Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Medicare SELECT is a Medigap plan that private insurers offer in some states.
Medigap plans pay for some out-of-pocket costs from Original Medicare parts A and B. They are supplemental plans that run alongside Original Medicare coverage to pay for gaps in coverage. They may also cover some services that Original Medicare does not pay for, such as emergency overseas treatment.
A person with a Medicare SELECT policy may need to use hospitals or healthcare professionals within a specific network to fully access their plan’s benefits.
People with Medicare SELECT have the option to change to a standard Medigap plan within 12 months of signing up. With other types of Medigap plans, a person may end up paying a higher premium or facing exclusions for preexisting conditions if they switch plans outside of the 6-month Medigap open enrollment period.
This is known as a guaranteed issue right. These rights apply to specific circumstances and mean that an insurance provider must provide coverage, not charge more, and not decline preexisting conditions solely because the individual applied outside the Medigap open enrollment period.
If a person needs to change Medigap plans because they move to a new state, they may also use their guaranteed issue right to switch to Medigap Plan A, B, C, D, F, G, K, L, M, or N.
People should ask their insurer directly if they sell Medicare SELECT. Those who move out of their state and no longer have access to the approved treatment network can buy a standardized Medigap plan from the same company if the new policy offers the same coverage or less.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
The cost of a Medicare SELECT policy depends on the insurance provider who sells it. As a result, Medicare SELECT plans may have a lower premium than other Medigap plans.
Medicare SELECT enrollees who do not use in-network hospitals or doctors for non-emergency treatment may be liable for some or all of the costs that Medicare does not pay.
However, even if a person uses a medical service from an out-of-network healthcare professional, Original Medicare will pay for its share of costs. Although, people should also know that Medicare SELECT will not cover any out-of-pocket costs for those services.
People with Medigap plans must also pay their Original Medicare Part B premium. In 2024, this will be $174.70 per month, although it may be higher for people with higher incomes.
Is Medicare SELECT a type of insurance?
Medicare SELECT is a type of insurance that covers some out-of-pocket expenses from Original Medicare if an enrollee receives eligible services from in-network healthcare professionals and medical facilities.
What is the difference between Plan G and Plan G SELECT?
Medicare Plan G does not restrict an enrollee’s network of healthcare professionals and medical facilities. However, Medicare Plan G SELECT would dictate a network of approved hospitals and doctors they can visit but may charge a lower premium.
Is a Medicare supplement plan the same as Medicare Advantage?
Medicare supplemental insurance, or Medigap, is different than Medicare Advantage. Both are privately administered, but Medicare Advantage includes coverage from Medicare Original parts A and B, as well as medication coverage for many plans.
Supplemental insurance only covers out-of-pocket costs, and a person cannot use Medigap and Medicare Advantage simultaneously.
What is the difference between Medicare Advantage and Medicare Part C?
Some insurance providers refer to Medicare Advantage as Medicare Part C, but they are the same type of plan.
Medicare SELECT is a type of Medigap plan, meaning it covers some out-of-pocket expenses from Original Medicare. People with a Medicare SELECT plan must visit a network of approved healthcare professionals and medical facilities to be eligible for full coverage. The premiums for Medicare SELECT plans are usually lower than other Medigap plans.
People can switch from a Medicare SELECT plan to a standardized Medigap plan within 12 months. However, Medicare SELECT plans are not available in every state. Those interested in getting a Medigap plan after getting Medicare Part B can speak with a range of insurers to see which options may be available in their area.