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As you age, it becomes even more important that you understand all of the health care coverage that is available to you. Most seniors receive coverage as part of the national Medicare plan. In addition to the standard Medicare Part A and Medicare Part B plans that are available to eligible citizens, there are a variety of supplemental plans that can be added to the basic policies. The purpose of these policies is to ease the financial burden associated with Medicare while also giving you peace of mind.
What is the Purpose of Medicare Supplemental Insurance?
A Medicare Supplement policy is intended to cover specific out-of-pocket costs that Medicare Part A and Medicare Part B do not pay. Known as Medigap coverage, this supplemental insurance may cover coinsurance, copayments, and deductibles. There are 10 different supplemental plans, labeled A, B, C, D, F, G, K, L, M, and N. In order to pick the best supplemental coverage for your personal needs and preferences, it is imperative that you understand the distinct features of each plan.
Depending on your needs and current financial situation, you can choose a Medigap plan that offers more comprehensive coverage but comes with a higher premium or you can choose a plan that boasts lower premiums in exchange for the buyer covering more of the gaps in coverage out of pocket.
Each Medigap policy requires a monthly premium. Every policy only covers one person. Therefore, if both you and your spouse want the additional coverage, you will need to purchase two plans. You can also choose to purchase different plans, depending on your specific current and anticipated health needs.
Comparing the Various Medigap Plans
It can be challenging to ascertain what plans are the best. Because every health situation is unique, it is important that you consider each supplemental plan in relation to your own personal needs. While the most popular plans are Plan G and Plan F, each plan offers a different level of coverage and benefits.
Every year, Medicare publishes a booklet that provides a side by side comparison of each Medigap plan. The annual comparison chart allows prospective buyers to compare the varying Medicare supplement plans.
Here is an overview of the 10 unique Medigap plans and what differentiates them from their counterparts:
Medigap Plan A
This plan is the most basic Medigap offering. The biggest selling point of this plan is that it covers the remaining 20% that the standard Medicare does not pay for all outpatient treatments. It is required that all insurance carriers provide for the option of a Plan A supplement. Despite this overall umbrella requirement, there are still states that do not mandate that insurers offer Plan A to people under the age of 65 who are covered under Medicare disability. If this is your situation, you will need to check with your insurer to see if Plan A is offered.
Medigap Plan B
This plan includes all of the benefits of Medigap Plan A while also adding in the Medicare Part A hospital deductible. Plan B is designed to pay the leftover costs after Medicare pays. Many people accidentally confuse Medigap Plan B with Medicare Part B. The traditional Medicare Part B is part of the original Medicare package that covers outpatient treatments.
Medigap Plan C
This plan is one of the most comprehensive supplement plans, providing more benefits than some of the other Medigap plans. Medigap Plan C covers everything except for the extra charges of Medicare. This coverage entitlement covers both deductibles as well as the additional 20% that is usually owed for any outpatient costs. Because of this extensive coverage, Medigap Plan C is a popular choice for those looking to take the worry out of having to pay extra costs.
Medigap Plan D
This bare-bones plan does not pay the Part B deductible. It also does not cover any of the excess charges of Medicare. Medigap Plan D may be a good plan for those looking for minimal coverage at lower prices. Be careful to not confuse this plan with Medicare Part D, which is the drug coverage portion of all Medicare plans.
Medigap Plan F
This plan has traditionally been the most popular supplement for Medicare coverage. This extensive plan covers virtually everything, leaving subscribes with no out of pocket costs for services that are covered under Medicare. With this plan, you will never have a copay for doctor visits or hospital admissions. While it comes with a high cost, it gives you a supreme peace of mind knowing that you will not be on the hook for unexpected expenses. Medigap Plan F also offers coverage outside of the United States up to the limits of the plan, making it a good choice for those who travel frequently. If you do not want to shell out as much money upfront for the monthly premium, you can choose the alternate high-deductible version of Medigap Plan F. This version delivers exceptional Medigap coverage once you hit the deductible.
Medigap Plan G
This unique plan has been growing more popular. Medigap Plan G provides all of the benefits of Plan F with the exception of the Part B deductible. Because the monthly premiums for Medigap Plan G can be extremely competitive, many subscribers choose this plan over the more popular Plan F. If you are on the fence between Plan G and Plan F, be sure to compare the monthly premiums and annual total costs in your state before making your purchasing decision.
Medigap Plan K
Plan K is a good choice for relatively healthy subscribers, covering 100% of the Part A coinsurance and hospital costs. Plan K also covers 50% of each of the remaining Medigap benefits related to Medicare Part A and the Part B copayment. A subscriber to Plan K will also receive blood need benefits and nursing facility care. With Plan K, you will not have coverage of the Part B deductible or excess charges or medical costs while traveling internationally. This plan is ideal for those clients who are beginning to age into the Medicare system and do not anticipate having a substantial amount of additional health care needs.
Medigap Plan L
This plan is most similar to Plan K but with a few more benefits. Just like Plan K, this plan covers all of the Part A coinsurance and hospital costs but does not pay any of the Part B deductible or excess charges. However, Medigap Plan L will cover 75% of the benefits that are related to Medicare Part A, the Part B copayment, blood need, and nursing facility care. This is an increase of 25% over the Plan K coverage allotment.
Medigap Plan M
This plan was created in 2010 in an effort to decrease the national budget deficit by reducing the amount of wasteful spending at the hands of too many doctor visits. Medigap Plan M covers all of the Part A coinsurance as well as hospital costs and the copays for hospice care. The plan also pays for all of the Part B coinsurance, the first three pints of blood, and the extra costs associated with skilled nursing care. This plan also covers 50% of the Part A deductible and 80% of medical costs incurred while traveling internationally. This plan does not pay for any of the Part B deductible or its excess charges.
Medigap Plan N
This plan boasts lower premiums. However, you will be charged for copays for routine doctor appointments and emergency room visits. Medigap Plan N also does not cover the excess charges of standard Medicare excess. This plan is a good choice for those subscribers who only anticipate going to the doctor a few times per year and who want many of the benefits of Plan F without the higher premiums.
What is the Difference Between Medigap Plans and Medicare Advantage?
While they may seem similar in benefits, it is important that you understand that there is a difference between Medigap Plans and Medicare Advantage. Also known as Medicare Part C, a Medicare Advantage Health Plan is more similar to a traditional private insurance health plan. With this type of plan, the subscriber would enroll through a private insurance company instead of paying for Parts A, B, and D separately. In some instances, this would cover all of the benefits provided by Parts A, B, and D along with extra services and advantages.
The majority of the available Medicare Advantage Health Plans provide services such as office visits, lab tests, and surgeries with a small copay. Some plans may even give you the option of signing up for an HMO or PPO network plan while also limiting what you pay out of pocket.
Each Medicare Advantage Plan has unique rules and advantages. For example, while most plans deliver prescription drug benefits, some plans may necessitate that you have a referral when you want to see a specialist. Depending on the plan, it may only cover physicians and clinics that are a part of their network of providers. This makes it more difficult to figure out your coverage limits and benefits as opposed to a supplemental Medigap Plan.
Deciding to go with a Medigap Plan will usually result in a higher premium, but lower out of pocket costs when compared to most Medicare Advantage Health Plans. Another factor to consider is your lifestyle. Because Medicare Advantage Health Plans are offered regionally, a Medigap Plan is usually a better choice for snowbirds who frequently change residences or for people who tend to travel a lot.
Note that it is illegal for a company to try to sell you both a Medigap Plan and a Medicare Advantage Health Plan at the same time.
One of the biggest advantages of the specific Medigap policies is that clients are given access to any physician that participates in the Medicare coverage. This enables you to see thousands of health care providers located all over the country. Because it does not matter what insurance company is providing your Medigap plan coverage, you are free to see any physician that accepts Medicare. This access takes the hassle out of trying to find a doctor that will accept your supplemental coverage. Over 90% of all primary care doctors in this country accept Medicare, giving you unprecedented access to the health care that you prefer. The simplicity of use for Medigap coverage makes it easier to understand than Medicare Health Advantage Plans.
Medicare has an official enrollment period time of seven months. During this initial enrollment period (IEP), insurance companies cannot deny coverage nor can they charge customers more for preexisting conditions. After this seven-month IEP, those stipulations of guaranteed coverage go away. If you do not purchase your preferred Medigap plan during this IEP, you run the risk of being turned down based on your current health. Or the insurer may accept you for the Medigap plan but then decide to set higher prices for your specific policy due to a preexisting condition. For this reason, it is important to purchase your Medigap plan when you first enroll in Medicare. Delaying the enrollment could cost you a significant amount of money should your health deteriorate down the road.
Exclusions to Consider
There are three states that standardize Medigap Plans according to different rules. If you live in Massachusettes, Minnesota, or Wisconsin, you will want to check with the specific standards of your state before deciding on a plan.
It is also important to remember that Medigap policies do not cover long-term care, dental care, vision benefits such as appointments and eyeglasses, hearing aids, or private nursing. Most of the Medigap plans also do not cover prescription drugs. Be sure to factor these costs into your overall health insurance costs.
It is not uncommon for all of this information and data to leave your head spinning. Fortunately, there is an abundance of resources available to help you to compare plans. In addition to the official Medicare comparison charts, you can also consult the assistance of an insurance advisor. The most important components to completely understand when comparing options are the total costs, health care provider networks, coverage levels, and maximum out-of-pocket expenses for each type of plan.
Before you decide on the best Medicap coverage for your needs, it is important that you shop around to compare rates. While it can be tempting, try not to compare your policy choices to those around you. There is no one-size-fits-all policy when it comes to Medicare supplemental plan options. You are the architect of your health insurance plans, making it important that you clearly understand the benefits that you are getting for your money. With the right research and execution, you can help to ensure that you are not left without the coverage that you need.
General Medicare Supplement Questions
This section answers your general questions about Medicare Supplement plans.
What is the best Medicare supplement plan?
There’s no singly best Medicare Supplement plan. You should evaluate the different options based on your needs and goals to decide which one is right for you.
Can I buy a Medicare supplement at any time?
Yes, if you are under 65 and have Medicare, then you can buy a Medicare Supplement plan at any time.
How do I choose Medicare supplemental insurance?
You should choose supplemental Medicare insurance based on your needs. For example, if you want to ensure you don’t have any out of pocket costs, then you’ll favor Medicare Supplement Plan F.
Do I really need supplemental insurance with Medicare?
That depends on your specific situation. Medicare supplement plans allow you to avoid out-of-pocket costs for going to see the doctor. If you see the doctor frequently, then a supplemental insurance plan can save you lots of money.
What percent of Medicare patients have supplemental insurance?
Most sources estimate that nearly 90% of Medicare beneficiaries have some form of supplemental insurance plan.
Do I need supplemental insurance if I have Medicare?
You aren’t required to have supplemental insurance if you have Medicare, but supplemental insurance will pick up some of the costs that Medicare doesn’t cover, like certain fees and deductibles. Also learn more about life insurance no medical exam required if you're shopping for that too.
What is a good Medicare supplement plan?
There are lots of great options for Medicare supplement plans. Plan F is the most popular, as it gives the greatest amount of coverage.
Is there an open enrollment period for Medicare supplements?
The open enrollment period for Medicare Supplement plans runs from October 15 to December 7, 2019.
When can I buy a Medicare supplement plan?
You can buy a Medicare supplement plan during the open enrollment period or during the window specified when you are enrolled in Medicare.
When can I change my Medicare supplemental insurance plan?
You can change your Medicare supplemental insurance plan during the open enrollment period. In 2019, that period runs from Oct 15 to Dec 7.
Can you have two Medicare supplement plans?
You cannot have two Medicare supplement plans. You can also not have both a Supplemental and Advantage plan.
Why do I need supplemental insurance with Medicare?
Supplemental insurance with Medicare pays for the costs that Medicare doesn’t pick up by itself, including deductibles and certain fees. Some people prefer the best short term health insurance for various reasons.
Do I need to renew my Medicare supplement plan?
Not in most cases. Medicare supplemental plans will continue to renew as long as you pay your premiums.
How many Medicare supplement plans are there?
There are 10 different Medicare supplement plans that are labeled with different letters.
What is the most popular Medicare supplement plan?
Plan F is the most popular Medicare supplement plan. More than 66% of Medicare recipients use Plan F.
When can I apply for Medicare supplemental insurance?
You can apply for Medicare supplemental insurance during the open enrollment period each year, or in the window given after you first enroll in Medicare. Learn more about how to apply for health insurance and other useful information.
When can I change my Medicare supplement policy?
You can change your Medicare supplement policy during the national open enrollment period each year.
What is the open enrollment period for Medicare supplements?
The open enrollment period for Medicare supplements always runs from the middle of October to the first week in December. In 2019 the period is Oct 15 to Dec 7.
Can you change Medicare supplement plans during open enrollment?
Yes, you can change Medicare supplement plans during the open enrollment period.
What is the best rated Medicare supplement insurance?
Anthem, Blue Cross Blue Shield, Mutual of Omaha, Aetna, Cigna and United American are the most highly rated Medicare supplemental insurance providers.
Do I need supplemental insurance with Medicare Advantage?
You do not need supplemental insurance if you have Medicare Advantage. In fact, you cannot have supplemental insurance with Medicare Advantage.
Specific Medicare Supplement Plans
We’ll answer questions about specific Medicare Supplement plans in this section.
What is the difference between Medicare Advantage and Medicare Supplement?
The difference between Medicare Advantage and Medicare Supplement is where your primary services come from. Medicare Advantage is administered through private health insurance companies, whereas Medicare customers that use supplemental plans have their primary Medicare run by federal programs.
Can you be turned down for Medicare supplemental insurance?
You can be turned down for Medigap or Medicare supplemental insurance by private companies for pre-existing conditions if you attempt to enroll outside the open enrollment periods. Learn more about pre existing condition medicare supplement insurance.
Are all Medicare supplement plan F the same?
Yes, Medicare plan F is the same across insurance companies.
What is Medicare part b supplemental insurance?
Medicare part B is supplemental insurance that covers the costs of medical bills for Medicare users, compared to part A which covers hospital bills.
What is Medicare part f supplemental insurance?
Medicare part F supplemental insurance is an insurance product that covers all deductibles, copays, and coinsurance, so you have no out of pocket costs.
Is plan F the best Medicare supplement?
For many people, yes. Plan F makes sure that you don’t have any out-of-pocket costs beyond what you pay for insurance.
Do I need Medicare supplemental insurance if I have Medicaid?
Not in most cases. Most Medicaid beneficiaries don’t obtain any additional insurance to supplement their coverage.
What is the difference between Medigap and Medicare supplemental insurance?
There’s no difference between Medigap and Medicare supplemental insurance. Both names refer to the same products.
Is Medigap and Medicare supplement the same thing?
Yes, Medigap and Medicare Supplemental Insurance are the same thing.
Is medical sharing like supplemental insurance?
No, medical sharing is like it sounds wherein the members of the service share the costs of medical expenses. For example take a look at our Liberty Healthshare vs Medishare review to see the main differences.
Medicare Supplement Coverage
This section answers the most popular questions about Medicare Supplement Coverage.
Do Medicare supplement plans cover chiropractic care?
Medicare Part B will cover 80% of the costs for chiropractic care for medically necessary reasons.
Does Mutual of Omaha Medicare supplement offer Silver Sneakers?
The program is available to Mutual of Omaha customers, but you will need to specifically enroll in the program to get the benefits.
Do Medicare supplement plans cover hearing aids?
Most Medicare supplemental plans don’t cover hearing aids or appointments to get fitted for hearing aids.
Does Anthem Blue Cross Medicare supplement cover Silver Sneakers?
Yes, Anthem Blue Cross Medicare supplement customers have access to the Silver Sneakers plan.
What is the most comprehensive Medicare supplement plan?
The most comprehensive Medicare supplement plan is Part F. This plan covers all deductibles, copays, and coinsurance so you don’t have any out of pocket costs.
Do Medicare supplement plans cover prescription drugs?
No, Medicare supplement plans don’t cover prescription drugs. Medicare offers separate prescription drug plans.
Do any Medicare supplement plans cover acupuncture?
No, there aren’t any Medicare plans that cover acupuncture.
Does Medicare supplement cover dental and vision?
No, Medicare supplement plans don’t cover dental or vision. This is why some people just opt to buy contacts online out of pocket for example.
Does Medicare supplement cover home health care?
Depending on the circumstances, Medicare parts A or B will usually cover home health care.
Does Medicare supplement plan G cover deductible?
Medicare supplement plan G does not cover the Part B deductible, which costs $185.
What does Medicare supplement plan F cover?
Medicare supplement plan F covers all deductibles, copays, and coinsurance. That means no out of pocket costs for you.
What does Medicare supplement plan J cover?
Part J pays the Part A deductible and the Nursing coinsurance. It also covers up to $120 for preventative care not covered by Medicare.
What does plan G Medicare supplement cover?
Medicare Plan G covers all out of pocket costs with the exception of the Plan B deductible.
Medicare Supplement Costs
We’ll help you understand Medicare Supplement Costs in this section.
How much does Medicare supplement plan G cost?
The average monthly premium for Medicare Supplement Plan G is $290 per month.
What is the average cost of supplemental insurance for Medicare?
The average monthly premium of supplemental insurance for Medicare depends on your supplemental plan. A – $360, B – $449, C – $347, D – $299, F – $326, F (High Deductible) – $68, G – $290, K – $129, L – $236, M – $361, N – $210.
How much does it cost for Medicare supplemental insurance?
The cost of Medicare supplemental insurance changes based on several different factors, including the specific plan you’re considering. Use an online tool or talk to an insurance agent to get an idea on how much you would pay for a Medicare supplement plan.
What is the least expensive Medicare supplement plan?
On average the least expensive Medicare supplement plan for monthly premiums is Part F (High Deductible). This plan costs an average of $68 per month.
Other Medicare Supplement Questions
This section covers Medicare Supplement questions that don’t fit into our other categories. Check here if you can’t find your question elsewhere.
What is the best Medicare supplement plan in Pennsylvania?
The best Medicare Supplement plan in Pennsylvania is the one that best meets your needs. The state has a helpful chart showing the differences in coverage on their insurance website.
Are all Medicare supplement plans the same?
No, all Medicare supplement plans are not the same. Each of the plan parts provides different coverage. For example, Part K covers 50% of the Part A deductible, but part F covers 100% of this deductible.
Can a doctor refuse a Medicare supplement?
Any doctor that accepts Medicare cannot refuse a Medicare supplement plan.