What Is Medicare SELECT?

Medicare coverage can come in lots of parts and through different types of insurance plans. There is Original Medicare, which includes Part A and Part B to provide basic hospital and medical coverage. Part D covers prescription drugs. Medicare Advantage (Part C) plans can roll some or all of these parts into a single plan offered by a private health insurance company.

 In addition, there are Medicare Supplement plans (also called Medigap) that help fill in the gaps in Medicare coverage. Medigap plans pay for out-of-pocket Medicare costs such as deductibles, coinsurance, copays and more.

Medigap plans can also come in many forms. One type of Medicare Supplement plan is known as Medicare SELECT. 

What is a Medicare SELECT Plan?

Medicare SELECT is a Medigap policy. It is called SELECT because it is selective in the number of local hospitals and doctors you can choose from to provide your medical care. Limiting choices to a local network can make these types of plans more affordable and a good choice for some people.

As with other types of Medigap plans, Medicare SELECT helps you pay for costs that Medicare parts A and B doesn’t cover, such as:

• Medicare Part A deductible for inpatient care (which is $1,632 per benefit period in 2024)
• Coinsurance payments for Medicare Parts A and B
• Hospital costs for up to 365 days past Original Medicare’s coverage
• Three pints of blood
• Foreign travel insurance

Every Medigap plan is different and covers different amounts of these costs, and some plans may not offer the benefits listed above. Generally, more coverage requires a higher monthly premium. Medicare SELECT is the same.

You can use the comparison chart below to view the types of benefits offered by Medicare Supplement plans side by side.

What Does Medicare SELECT Cover?

Medicare SELECT, which was introduced in the early 1990s, is offered by private insurance companies that provide Medigap plans.

Medicare SELECT plans pay for the same costs that the standard version of the same type of Medigap plan covers. For example, Medicare SELECT Plan G covers the same out-of-pocket costs as standard Medigap Plan G. 

The difference is that a Medicare SELECT plan limits the doctors and hospitals you can access for health care. Medicare SELECT plans negotiate with these doctors and hospitals for better pricing. Limiting the provider network allows the plan to control costs, resulting in lower monthly premiums.

However, Medicare SELECT plans can also restrict your choices: in other ways

• Many hospitals and other care facilities will be out of network, so your Medicare SELECT plan may not cover the gaps in Medicare (Medicare deductibles, coinsurance, copays, etc.) for treatment received at the out-of-network facility. It will only cover care received from in-network facilities, except for emergencies.
  
  
• Medicare SELECT plans typically require referrals from a primary care physician for care from specialists or at a network hospital.
  
  
• Medicare SELECT plans are only offered in certain areas. Before purchasing a plan, be sure that the policy you choose includes your preferred hospitals and doctors in its network.

What Medicare Costs Could I Be Responsible For?

Getting care from a provider that is outside of the approved Medicare SELECT network will mean you must pay the 20% of costs Medicare Part B doesn’t cover, along with all other costs not covered by your Original Medicare coverage (Part A and Part B).

For example, if you suffer a heart attack or cognitive decline, your Medicare SELECT plan may not include a leading cardiac care hospital or dementia physician in your area. This would make you liable for the extra costs of the more advanced care, or the situation might force you to accept care from an in-network option that you may not prefer.

If you receive care from in-network providers, however, your Medicare SELECT plan would minimize your out-of-pocket costs by paying for your Medicare costs for covered care, according to the type of plan you have.

Where Is Medicare SELECT Offered?

Medicare SELECT plans are not available everywhere in the United States. Private insurance companies are allowed to offer plans in every state, but not all choose to do so. Those plans also can choose which services they will cover and which they will not cover, so coverage may differ from one plan to another and from one area to another.

If you are interested in a Medicare SELECT plan, you are encouraged to shop around among the insurance companies in your area. A licensed insurance agent can help you compare which services they do and do not cover and compare that coverage with premium rates for a regular Medigap plan that may be available where you live.

You can find out more about Medigap policies – including Medicare SELECT plans – that may be available in your area by using our online Medigap plan finder tool or calling to speak with a licensed insurance agent.

Is Medicare SELECT the Best Option for You?

In comparing Medigap plans, including Medicare SELECT plans, it’s important to ask yourself and your loved ones some questions:

• Can you afford any type of Medicare supplemental plan? If you determine that your budget can support a Medicare Supplement plan, then look into all the plan options in your area, including Medicare SELECT.
• Do the Medicare SELECT options in your area cover the services you want? All Medicare SELECT plans are different, so be sure any plan you choose gives you coverage for the care and services you need and want.
• Do the cost savings outweigh the network restrictions? Compare the money you may save on premiums – which may range from only $10 or $20 to hundreds of dollars per month, – with the loss of choice that comes with having your providers restricted.

When Can You Enroll in Medicare SELECT?

Medicare.gov explains that the best time to enroll in a Medicare Supplement plan – including Medicare SELECT plans – is during your Medigap Open Enrollment period. This window blasts for 6 months, and it begins as soon as you are at least 65 years old and enrolled in Medicare Part B.

If you enroll during this window, you have what’s called a guaranteed issue right. If you apply for a Medigap plan while you have a guaranteed issue right, insurance companies cannot use medical underwriting to charge you higher plan premiums or deny you coverage altogether based on your health.

You also can cancel a Medicare SELECT coverage plan 12 months after you originally sign up for it, if you decide you no longer what to be enrolled in the plan.

A licensed insurance agent can help you review your options for Medicare SELECT plans and other Medicare Supplement plans in your area.