Medicare Supplements (Medigap)

What Are Medicare Supplement Plans?

Medicare Supplement Plans, also known as Medigap, are insurance policies sold by private companies to help cover the “gaps” in Original Medicare (Parts A and B). While Medicare covers many healthcare costs, there are still out-of-pocket expenses such as copayments, coinsurance, and deductibles. Medigap policies are designed to help fill these gaps, giving you more predictable healthcare costs.

Why Do You Need Medicare Supplement Plans?

Original Medicare doesn’t cover everything. You may still face significant out-of-pocket costs for things like:

  • Deductibles: The amount you must pay for healthcare services before Medicare begins to pay.
  • Coinsurance: The percentage you pay for medical services after Medicare pays its portion.
  • Copayments: The fixed amount you pay for a specific service, like a doctor’s visit.

Medicare Supplement Plans are designed to reduce these expenses and provide financial protection. By paying a monthly premium for a Medigap policy, you can limit your out-of-pocket costs and avoid unexpected medical bills.

What Does Medicare Supplement Cover?

Each Medicare Supplement plan offers a different level of coverage. However, all Medigap plans are standardized, meaning they must follow federal and state laws to provide specific benefits. Here are some of the key benefits that Medicare Supplement Plans may cover:

  • Part A Hospital Coinsurance and Hospital Costs: After your Medicare Part A coverage is exhausted, Medigap can cover hospital costs for up to an additional 365 days.
  • Part B Coinsurance or Copayments: This helps cover the 20% of Medicare-approved expenses that Part B doesn’t pay.
  • Blood: Medigap policies cover the first three pints of blood you need for a medical procedure.
  • Part A Hospice Care Coinsurance or Copayments: Medigap can help pay for costs associated with hospice care.
  • Skilled Nursing Facility Care Coinsurance: If you need skilled nursing facility care after hospitalization, some Medigap plans will cover your share of the costs.
  • Part A and B Deductibles: Some Medigap plans cover the deductible you would otherwise pay out-of-pocket under Original Medicare.

Types of Medicare Supplement Plans

Medicare Supplement Plans are categorized into different lettered plans (e.g., Plan A, Plan B, Plan F, Plan G, Plan N). Each plan offers a different combination of benefits:

  • Plan A: The most basic plan, covering Medicare Part A and B coinsurance, but it doesn’t cover deductibles.
  • Plan F: The most comprehensive plan, covering all out-of-pocket costs not paid by Original Medicare, including deductibles. However, Plan F is no longer available to new Medicare beneficiaries after January 1, 2020.
  • Plan G: Offers similar benefits to Plan F, except for the Part B deductible. Plan G is popular among new beneficiaries seeking robust coverage.
  • Plan N: Provides a lower-cost option, covering most out-of-pocket expenses but requiring small copayments for doctor visits and emergency room trips.

Note: Plans are standardized differently in Massachusetts, Minnesota, and Wisconsin.

How to Choose the Right Medigap Plan

When selecting a Medicare Supplement Plan, consider the following factors:

  • Healthcare Needs: Review the services you frequently use, such as hospital visits or outpatient care, to find a plan that covers these costs.
  • Budget: Consider both the monthly premium and the out-of-pocket expenses you’re comfortable with. Plans with higher coverage tend to have higher premiums.
  • Travel: If you travel frequently or spend part of the year outside the U.S., some Medigap plans provide emergency care coverage when traveling abroad.

How Medicare Supplement Plans Work

  • Who Is Eligible for Medigap?
    To be eligible for a Medigap policy, you must already have Medicare Part A and Part B. The best time to buy a Medicare Supplement Plan is during your Medigap Open Enrollment Period, which begins the first month you’re 65 or older and enrolled in Part B. During this time, you can buy any Medigap policy sold in your state, regardless of your health.

  • What Isn’t Covered by Medicare Supplement?
    Medigap policies generally don’t cover long-term care (such as nursing homes), vision or dental care, hearing aids, or private-duty nursing. It’s also important to note that Medigap plans do not include prescription drug coverage—for that, you’ll need to enroll in a separate Medicare Part D plan.

What to Know Before You Buy

  • Premiums Vary: Although Medigap benefits are standardized, premiums can vary depending on the insurance company, your location, and your age. Make sure to compare pricing among different insurers to find the best rate.
  • No Network Restrictions: Unlike Medicare Advantage, Medigap plans don’t have network restrictions. You can see any doctor who accepts Medicare, regardless of the Medigap plan you choose.
  • Guaranteed Renewable: As long as you pay your premium, your Medigap policy cannot be canceled, even if you have health problems.

Get the Extra Coverage You Need with a Medicare Supplement Plan

Don’t leave gaps in your Medicare coverage. With the right Medicare Supplement Plan, you can enjoy peace of mind knowing your out-of-pocket expenses are covered. Whether it’s coinsurance, copayments, or deductibles, a Medigap policy helps protect your finances and gives you more control over your healthcare.

Use our free comparison tool to find the perfect Medicare Supplement Plan for your needs and budget. Our licensed agents are here to answer any questions and guide you through the process.

OUR BUSINESS ADDRESS

FOLLOW OUR PROFILES

Medicare AdvantageUS

Questions? Speak with an Expert