What is Medicare SELECT?
Medicare SELECT is a form of Medicare Supplement insurance that requires you to use specific medical facilities and doctors that are within the plan’s network.
Medicare SELECT v.s. Medigap
Unlike regular Medigap plans that provide coverage for approved services performed anywhere that accepts Medicare, Medicare SELECT policies are more restrictive.
Your insurance provider pre-determines a network of hospitals, medical offices, and medical providers. You must get treatment from those approved facilities, or your Medicare SELECT policy won’t help pay for your treatment.
Medicare SELECT policy versions are offered for any one of the 10 standardized Medigap plans available in most states. Other than the restrictions placed on which medical facilities you may use, Medicare SELECT policies must meet all other regulations required by the standardized Medigap plans.
Medicare SELECT policies generally cost less than other standardized Medigap policies.1
Medicare SELECT policies were introduced in 1990, according to the Kaiser Family Foundation (KFF). About 900,000 people had Medicare SELECT plans in 2010. Medicare SELECT plans are not as popular as traditional Medicare Supplement insurance plans. Nearly 1 in 10 Medigap policies were Medicare SELECT plans in 2010, according to the KFF report.
Network restrictions with Medicare SELECT
You must go to an in-network provider to be eligible for full Medicare SELECT insurance features and benefits. If you use a provider or facility outside of the network, you might be liable for all of the costs that would otherwise be covered by your Medicare SELECT policies. However, the network restrictions do not apply to emergency services.
For example, Medicare Part B pays 80% of the cost of approved services. If you have a Medicare SELECT policy and use an approved provider, the insurance company will help pay for the remaining 20%. But if you use a non-approved provider for non-emergency care, you could be liable for the remaining 20%. Medicare will pay for its share of the approved service regardless of whether the Medicare SELECT insurance provider covers it or not.
Check with your medical provider and facility before receiving any medical service to help prevent non-covered out-of-pocket charges.
Medicare SELECT Policy availability
Plan availability varies based on location and insurance providers. If an insurance company decides to offer a Medicare SELECT plan, they do not have to offer one for each plan type. For example, a Medigap insurance company might offer only Medicare SELECT Plan F and N, despite offering all 10 regular Medigap plans.