Medicare Supplement Plans (Medigap)

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Medicare Supplement plans were created to supplement, or compliment, Medicare. Original Medicare covers 80% of your medical expenses.

Medicare Supplemental plans fill in the gap between Medicare’s payments and the actual amount billed.

These gaps include co-pays, deductibles, and coinsurance. With ten policy options, the best one for you depends on the level of coverage you need.

We’ll review:

  • Eligibility guidelines
  • When to enroll
  • Medicare Supplement insurance letter plan comparison
  • Important Medicare Supplement facts
  • Pricing/Costs
  • How to apply

Medicare Supplement Plans Eligibility Guidelines

To be eligible for Medicare Supplement plans, you must be at least 65 years of age and enrolled in Medicare Part B. In some states, Medicare Supplements are only available to those over the age of 65.

Other states allow those qualifying for Medicare due to disability to apply at any age. If you qualify, don’t wait to enroll.

Medicare Supplement Insurance Enrollment Period

You can enroll in a Medicare Supplement plan at anytime during the year, as long as your Part B is in effect.

Upon your enrollment in Medicare Part B, your Open Enrollment Period begins for Medicare Supplements. This window only occurs once and cannot be extended or changed.

Your Open Enrollment Period is six months long. During this period, you can purchase Medicare Supplement insurance with Guaranteed Issue. After this six month period, you’ll no longer have Guaranteed Issue, but you can still enroll.

However, without Guaranteed issue you’ll have to answer medical questions that could impact your acceptance odds. You could also end up paying more due to pre existing conditions.

If you’re over the age of 65 and don’t enroll in Part B when you’re first eligible, your OEP doesn’t start until you do enroll in Part B and it becomes effective. Important to note, if you don’t enroll in Part B when you’re first eligible, you could be penalized for each year you went without it.

The General Enrollment Period for Medicare Parts A & B is yearly between January 1st and March 31st. If you didn’t sign up during your Initial Enrollment Period, you can sign up during this time period.

Medicare Supplements Coverage Comparisons

Medicare Supplements coverage benefits are dependent on the letter plan you choose. These plans are standardized by the government.

The benefits are going to be the same per letter plan regardless of the carrier. The only difference is the cost, it’s up to the carrier to decide how much they want to charge for each letter plan.

A carrier can choose between three Medigap pricing methods to determine your premium.

Each letter plan includes the basic benefits, starting with Plan A, and adds additional benefits or levels of coverage.

This way, everyone can get the individual healthcare benefits they need to cover their out of pocket medical costs not covered by Original Medicare.

It’s important to note that these plans only cover one individual. If your spouse needs coverage, they’ll be required to purchase a separate policy.

You can review the top Medicare Supplement plans by clicking here.

10 Medicare Supplemental Letter Plans Breakdown

Medicare Supplements include Plan A, B, C, D, F, G, K, L, M, N, and a high-deductible Plan F.

  • Plan A helps fill in the gaps with co-payments, deductibles, and coinsurance.
  • Plan B will cover virtually all hospitalization costs. This plan will also cover skilled nursing facility costs as well as hospice care deductibles.
  • Plan C is one of the most extensive plans and covers almost every cost. The only exceptions are Part B excess charges, hospitalization after 365 days, and nursing care after 101 days.
  • Plan D is extensive as well and covers everything except hospitalization after 365 days and nursing care after 101 days. It also doesn’t cover Part B deductibles.
  • Plan F is considered to be one of the most popular available plans, as it covers your Medicare Part B deductible as well as the services covered in Plan D.
  • High-deductible Plan F covers the same benefits as Plan F. The difference is it requires a higher deductible before coverage starts.
  • Plan G is very popular, as it covers many of the Part B deductibles.
  • Plan K pays half of the Part B deductibles and coinsurance for hospitalization. This plan has an out-of-pocket maximum, allowing participants to better plan their expenses.
  • Plan M provides extensive coverage but only covers half of your Part A deductible for hospitalization.
  • Plan N has extremely low premiums compared to other plans. It requires a small co-payment for some office and hospital visits.

Plans G, K, L, M, and N tend to have lower premiums, but higher out-of-pocket costs.

Important Facts to Know About Medicare Supplement Plans

  • Some policies sold before January 1, 2006, provided prescription drug coverage. If your policy no longer offers this, you may be eligible to join a stand alone Medicare Part D Prescription Drug Plan.
  • Policies only provide coverage to the policyholder. If you want coverage for your spouse or family member, they will have to purchase their own policy.
  • It’s only available for individuals who already have both Medicare Part A and Part B.
  • By law,  policies must be renewable even for individuals with health conditions. In other words, you can never lose your policy if you pay your monthly premiums.
  • Any insurance company licensed to do business in your state can sell policies.
  • Policy premiums are in addition to any Medicare Part B premiums.
  • You cannot have overlapping coverage provided by both a Medigap and Medicare Advantage Plan policy.
  • It’s illegal to sell someone a policy if they have a Medicare Medical Savings Account (MSA) plan.

There are a number of insurance policies that resemble Medicare Supplements but are not:

  1. Veterans’ benefits (VA)
  2. Tribal and/or Indian Health Service coverage
  3. Medicare prescription drug plans (Part D)
  4. Medicaid
  5. State-level aid
  6. Medicare Advantage Plans (including HMOs, PPOs, and fee-for-service plans)
  8. Long-term care insurance
  9. Employer/union plans, including FEHBP (Federal Employees Health Benefits Program)

Pricing and Coverage

It’s important to note that prices and premiums vary by insurance company and state. To find a policy right for you, consult one of our state licensed senior agents today!

Medicare Supplement insurance can be helpful in paying out of pocket fees for Medicare Part B and/or Part A claims. Most policies include provisions for allowing your Medicare claim information to be sent to your insurer. They will pay the doctor or healthcare provider directly.

When shopping for a policy, be careful to assess “apples to apples.” In other words, make sure that the price you’ve been quoted for one type of coverage is equivalent to the same type of coverage provided by another company. Medicare beneficiaries should take their time when selecting a policy.

Additional Medicare Supplement Plan Resources

Depending on where you live, you may be eligible to purchase a certain kind of policy called Medicare SELECT. These Medicare SELECT policies provide a built-in escape clause to allow you to change your policy within the first year with no penalties.

We have a variety of resources that are available to you. Our FAQ pages answer top frequently asked questions about Medicare Supplemental plans.

We also have a blog we update regularly. Our goal is to keep you well informed and up to date with the latest healthcare news.

Don’t go anywhere without watching our senior agent education videos. Our experienced Medicare Supplement agents talk about the different supplemental Medicare insurance options available.

You can also check out our agent review page here.

Apply for Medicare Supplement Insurance Online

Plans vary by state, so talk to an expert who can help you find affordable Medicare Supplement insurance plans in your area. Our representatives will help you sign up for coverage as soon as possible.

Simply call our licensed representatives so we can provide an estimate. The screening questions are simple and will help us ensure that you receive the right plan for your needs.

If you prefer to compare rates online, simply complete our rate comparison form here.