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Do I Really Need Supplemental Insurance with Medicare?


If you have Original Medicare, a Medicare Supplement plan may help you cover the costs of your healthcare, therefore saving you money. This is because, while offering great benefits, Medicare Part A and Part B will not cover all of your healthcare costs, leaving you with expenses to cover. When you consider your deductibles and copays, Medicare Supplement premiums start to make more sense for many.

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So, is supplemental Medicare insurance a waste of money? For many, the answer is no. But because the healthcare needs and budgets of Medicare enrollees differ vastly, it’s difficult that have a singular answer. There are also several types of Medicare Supplement plans available, helping address a variety of needs.

Below, we dive into the important questions seniors have about their Medicare supplemental benefit options. Discover if supplemental insurance is worth it for Medicare coverage, your additional options, and how to compare plans and rates for your benefits.

Do I Need a Medicare Supplement?

While tens of millions of Medicare beneficiaries are enrolled in a Medicare Supplement plan, valuable coverage may be right for you. But it’s helpful first to understand what the plans do, along with the costs left by Original Medicare:

  • Without having a Medigap plan, you’re going to have out-of-pocket costs to contend with. For many, the premiums of Medicare Supplement coverage are cheaper than paying for these expenses. This can include deductibles, copayments, and coinsurances.
  • If you travel often, Medigap plans are also a great option because there are no networks. Otherwise, you may end up paying more for your healthcare.
  • If it’s approved by Medicare, it’s approved by Medicare Supplement coverage. There are 12 lettered plans to choose from, so benefits can differ, but you can apply your coverage to any Medicare-approved services.

The truth about Medicare supplemental insurance is that it can benefit many who can not afford to cover the expensive and rising costs of healthcare. Are Medicare Supplement plans necessary? That likely depends on your budget and risk tolerance.

Is Medigap Insurance a Waste of Money?

For many Medicare beneficiaries, Medigap insurance is not a waste of money and can help them save on expenses. The cost of Medicare Supplement plans is undoubtedly an important factor to consider, but so too are the out-of-pocket costs you can incur without one.

Medigap premiums range in price, and most people can find an option they can afford. When you assess the amount of money you’ll save on medical bills in the long run, paying a monthly Medigap premium often makes sense.

It’s important to note that Medigap premiums vary per individual. Even if you get the same plan as your next-door neighbor, your premiums likely won’t be the same. This range is due to a variety of factors that can affect premium rates, including your age, location, health, and the coverage you select.

Each Medigap plan is offered by private insurance carriers but standardized by the federal government. Furthermore, carriers vary in their rating methods, which is another component in determining your premium rates.

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As you can see, when exploring the different plan options, there are a lot of things to consider, including your future needs in mind. For example, if you are planning to travel, the amount of coverage and type of coverage you need for your healthcare can vary. Medicare Supplement plans are a great option to help mitigate these costs without regard for a network.

Is Medigap Worth It?

Medicare isn’t free, but healthcare can be expensive. Medigap is the same thing as Medicare Supplement and gets its name because it helps fill the gap in coverage left by Original Medicare benefits alone. Together, beneficiaries can enjoy little to no healthcare costs on approved services.

This means that while you’ll pay premiums in addition to your Part B premiums, you can still save money because of the costs Medicare Supplement plans will cover in the long run. Your coverage can help provide peace of mind and financial stability due to providing a more comprehensive form of coverage that comes with a Medigap plan.

Medigap plans are also accepted everywhere Medicare Assignment is, which is 98% of providers. This means you’ll most likely be able to keep your preferred providers and easily find specialists in your area.

Again, the key here is to consider your healthcare needs, as well as your financial situation. While many can benefit from a Medicare Supplement plan, others might find a Medicare Advantage plan better suits their needs.

Are Medicare Advantage Plans Worth It?

Medicare Advantage, also known as Medicare Part C, is also coverage available from private insurance companies that may be beneficial for your healthcare. These plans include the same benefits as Original Medicare and often provide prescription drug coverage and other perks, including dental, vision, and hearing.

Just as Medigap plans can benefit enrollees, Medicare Advantage plans can also work well for some individuals. If you have an Advantage plan, while it won’t replace your Original Medicare benefits, it will become your primary coverage. This means you won’t need a Medicare Supplement plan, which is good because you can only enroll in one or the other.

However, just as with a Medigap plan, you’re going to want to consider the personal factors that go into your healthcare and budget before enrolling. For example:

  • It’s important to know that with a Medicare Advantage plan, you’ll want to ensure your preferred doctors are in your plan’s network.
  • To see a specialist while enrolled in a Medicare Advantage plan, you’ll also need a referral in most cases. Therefore, if you frequently see healthcare providers, a Medicare Supplement plan may be a better option.

If you’re choosing between Medigap and Advantage plans, make sure to keep your future health and budget needs in mind as well as your current circumstances. Speaking with a licensed Medicare agent is a great way to determine both your present and future healthcare needs.

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Is Medicare Part D Worth It?

If you’re enrolling in a Medicare Supplement plan rather than an Advantage plan, prescription drugs won’t be covered. Therefore, if you’re looking to cover the cost of prescription drugs, a Medicare Part D plan can help you keep the rising costs of your medication low.

While no decision should be rushed, delaying enrollment is also not a good idea. If you delay enrollment, you could face a penalty for the life of your policy. This is why even if you don’t take any medications, a Part D plan may be worth it.

As you age, it’s important to consider that your healthcare needs will change and often grow. This means you could need more medication in the future than you do now. But by waiting to enroll until you do need the coverage, you’ll face penalties in the future that may not fit your budget and hinder your access to the prescription drugs you need.

Enrolling in a Medicare Part D drug plan now can help you safeguard against higher drug prices and future premiums. It’s important to note that the drugs covered by each plan will vary. If you’re currently on any prescriptions, you’ll need to check your plan’s formulary to ensure it offers coverage for your medication.

Is Supplemental Medicare Insurance a Waste of Money?

You’re already paying for the costs associated with Original Medicare, it’s natural to question why you need a Medicare Supplement plan and the additional costs that come with it. But rather than being a waste of money, for many, these benefits can be a great way to save money on healthcare expenses.

Having extra protection can help you in numerous ways, especially when hedging against the potential of large medical bills. Without supplemental coverage, the leftover costs after pricy medical procedures will be your responsibility if you are not properly prepared.

Therefore, if you’re looking to protect your finances from untimely, large medical expenses and additional costs from routine healthcare visits such as deductibles or copayments, rather than being a waste of money, Medicare Supplement plans may help save you money and provide peace of mind in the process.

Are Medigap Plans Worth the Cost in all States?

It doesn’t matter which state you’re in, the cost of a Medigap plan will continue to come down to personal factors. While the federal government regulates the benefits of all the plans, it doesn’t have any influence on their costs. But Medicare Supplement plan rates will vary in different insurance states, among other factors.

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For example, Medigap costs are different in Louisiana than they are in South Dakota. Even within each state, things such as age, zip code, whether or not you’re a smoker, and gender will all affect how much you pay for coverage.

Rather than wondering if a Medicare Supplement is worth it in your state, it’s better to compare different companies and plan options to avoid overpaying for the benefits you need. Comparing prices includes checking how insurance companies price their policies and the features that would contribute to increased rates.

Costs also vary from one letter plan to another, meaning that if you find a Medicare Supplement Plan G cheaper than a Medicare Supplement Plan F and qualify, you should see what different companies offer both Plan G and Plan F to make the best decision when choosing your coverage.

How to Find Out if a Medicare Supplement is Worth It for You

In Medicare, determining if supplemental insurance is worth it is important for every beneficiary. Having too little protection when it comes to your healthcare can cause you to pay more for these services when you shouldn’t have to. Medicare Supplement plans are there to help you and can minimize costs for many beneficiaries.

There are plenty of personal factors to consider when enrolling in a Medigap plan, including whether or not you travel, budgetary needs, and of course, healthcare. But if you’re looking to keep your out-of-pocket costs low, gain peace of mind, and maintain freedom when choosing a healthcare provider, it’s important to compare coverages among the best Medicare Supplement plans in your area.

Ultimately, if you find yourself asking, “Do I really need supplement insurance with Medicare?” the best thing you can do is review your coverage and budget needs with a licensed agent. Our team of experts can help. Call us today to review your coverage options, or fill out a compare rates form to see your rates now.

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Jagger Esch

Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and MedicareFAQ.com. Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

6 thoughts on “Do I Really Need Supplemental Insurance with Medicare?

  1. What does ptb Charges billed amt. $2310.00 Medicare approved $132.28
    Medicare payment $106.06 not covered 0.00 our payment $26.22
    This is on an explanation of benefits from Cigna.
    Does it mean Medicare negotiated the bill down to $132.28 from $2310.00?

    1. Hi Jim – $132.28 is the contracted amount. Meaning, Medicare says the doctor/hospital can only bill that amount for that procedure/visit.

    1. Hi Devinder! Yes, you need supplemental Medicare insurance if you don’t want to pay 20% out of pocket for all your outpatient services as well as deductibles.

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