Medicare SELECT: What Is It?

Simply put, Medicare SELECT is a Medigap policy (a supplemental insurance plan added on to Medicare) that confines your treatment options to a local group of hospitals and doctors. This can be financially advantageous to many people, but it’s not offered everywhere.

If you’re interested in learning about and actively considering Medicare SELECT, you probably already know what Medicare is. But either way, let’s discuss Medicare and Medigap, and how this policy relates. We’ll also discuss the history of Medicare SELECT and dig into more detail on what it is, where you can get it, and how to enroll in it.

What Is Medicare SELECT and How Does It Relate to Medicare and Medigap?

Think of Medicare as a presence across everything related to elderly healthcare. It mainly services people 65 and up, but there are a couple million people below 65 who qualify for coverage due to a disability or because they have end stage renal disease.

Its primary coverage options come in parts A and B. They cover varying costs like hospital stays, hospice care, doctors’ visits, medical equipment, skilled nursing care, and more. Part C of Medicare is called the Medicare Advantage Plan, which is a private plan that covers the same costs as parts A and B of Medicare and also includes dental, vision, and sometimes prescription drugs. The final part is Part D, which exclusively covers prescription drugs.

There is also supplemental coverage you can add to existing Medicare coverage that helps you pay for everything that Medicare doesn’t. This includes costs like:

• Deductibles for parts A and B
• Coinsurance payments for parts A and B
• Hospital costs for up to 365 days past Medicare’s coverage
• Three pints of blood
• Foreign travel insurance

Each supplemental plan—also known as a Medigap plan—covers varying percentages of costs. If you get more coverage on this supplemental plan, the monthly premium usually increases, too. There are 10 lettered Medigap plans—parts A, B, C, D, F, G, K, L, M and N. Medicare SELECT is another form of supplemental coverage.

Medicare SELECT was introduced to the Medicare supplemental coverage plan in the early 1990s. It allowed companies who offered Medigap services in “15 states to market network-based medigap products,” meaning that the plans would be developed based on the services available in the area, restricting which hospitals and doctors could be used.

Some of the original states included Alabama, California, Florida, Michigan, Texas, and Ohio. This offer was extended to all states in 1995 and then made a permanent law in 1998. The program will continue until the Secretary of Health and Human Services finds that Medicare SELECT isn’t saving the people who use it any money compared to what they’d be spending on regular supplemental Medicare plans.

Medicare SELECT covers everything a normal supplemental coverage plan does, except it restricts which doctors and hospitals you can get the coverage from. While this makes the monthly premium cost less, it also can prevent you from getting the absolute best care from a Medicare-approved physician. For example:

Let’s say you or a loved one develops a heart condition like coronary artery disease. This can eventually lead to a heart attack or stroke. You want the absolute best care at a surrounding heart hospital, but your Medicare SELECT plan doesn’t cover it at the best hospital near you. It might not cover a heart hospital around you at all. And now you’re left trying to cover all the extra costs Medicare doesn’t cover while still paying a monthly premium for Medicare SELECT.

On the flip side, Medicare SELECT adds another option for those who don’t have a large enough income to support yet another large monthly premium but still need help covering the costs not typically covered for parts A and B due to how often they use the services.

Where Can I Get and Use Medicare SELECT?

Medicare SELECT is not in every city or county in the United States. While insurance companies are allowed to develop programs in every state, it may not provide coverage in your specific region. And even if Medicare SELECT is available in your area, it may not cover all the services in your area.

If you go outside of the approved network of Medicare SELECT-approved doctors, you will be forced to pay the 20 percent of costs Medicare Part B doesn’t cover. You’ll also have to pay all other costs that aren’t covered by your Original Medicare or Medicare Advantage plan.

You should shop around multiple insurance companies and find out which services they cover in your area—if they cover services in your area at all. From there, you can find out the rates for coverage they offer and if it would be worth getting a SELECT plan or a regular Medigap plan.

You can find various Medigap policies, like SELECT, available in your area on the Medicare website.

Is Medicare SELECT the Best Plan for Me?

This is where you need to conduct an internal cost-benefit analysis. Some questions you may want to ask yourself when considering a Medicare SELECT plan include:

Can I Afford A Medigap Supplemental Plan?

Look at your monthly budget and see if you can afford a supplemental plan. Once you make that decision, then you can explore all the supplemental plans, including Medicare SELECT. All the options should be on the table.

Are The Savings Worth It?

Sure, you may save some money on a SELECT plan, but is $10 or $20, which could be the savings in some cases, worth having your care restricted? On the flip side, hundreds of dollars a month in supplemental premium savings could be very attractive to someone.

Is Medicare SELECT Offered In My Area?

This may seem obvious, but you have to make sure there are at least some SELECT services offered in your area before spending any money on one!

Do You Like The SELECT Services Offered In Your Area?

This is also extremely important. It’ll be difficult to enjoy and get your money’s worth of services if you don’t like the selection to choose from.

You have plenty of time (discussed in the next section) to decide if you want a Medigap plan, a Medicare SELECT supplemental plan, or any other supplemental plan, so ask yourself these questions, think about your answers, and then come to a decision.

How Do I Enroll in Medicare SELECT?

You can sign up for Medicare SELECT during the first six months after your Medicare Part B coverage starts. For example, if you sign up for Medicare two months after your 65th birthday, you will then have until eight months after said birthday to acquire a SELECT plan. Applying during this six-month window makes it so that private insurance companies can’t deny you coverage based on your previous health conditions.

Just like Medigap coverage, Medicare SELECT plans range from A to N, using the same lettered plans and covering the same things each of those plans do. Again, where SELECT differs is in who you can get the coverage from without having to pay all the deductibles and extra costs.

You need to have both parts A and B of Medicare to get a SELECT plan. You typically won’t be able to get a SELECT plan if you have a Medicare Advantage plan (Part C). You would have to switch to an Original Medicare plan in order to get a SELECT plan, too.

You can enroll in a SELECT program by contacting Medicare-approved insurance companies in your area and seeing if they offer a SELECT plan.

Can I Cancel Medicare SELECT Coverage?

Yes, you can cancel a Medicare SELECT coverage plan 12 months after you originally sign up for it if you find that it’s not really saving you any money in comparison to a regular Medigap supplemental plan.

If you have any questions regarding a Medicare SELECT plan, contact your local Social Security office or local insurance companies who offer the plan.