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Medicare Supplement (Medigap) Plans

Medicare Supplement plans cover some of the healthcare costs Original Medicare (Medicare Part A and Part B) leaves behind. These plans, also known as Medigap plans, are supplemental coverage that helps fill your coverage gaps, including copayments, deductibles, and coinsurance. As a result, when you have a Medicare Supplement plan, you will have little-to-no out-of-pocket costs for Medicare-covered services and equipment.

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What is a Medicare Supplement Plan?

Medicare Supplement plans are supplemental insurance policies that cover healthcare costs Original Medicare (Part A and Part B) leaves for you to cover. While Medicare Part A and Part B benefits come from the federal government, Medicare Supplemental plans have benefits delivered by private insurance carriers. These providers bill Medicare first and charge the remaining amount to the Medigap carrier.

In 47 states, Medigap plans are identified by letters A through N. Each lettered plan offers a different coverage level. This is a great feature of Medicare Supplements, as everyone has different healthcare and budget needs. By having multiple options available, beneficiaries can enroll in Medicare Supplement insurance plans that fit their specific needs.

What is a Medicare Supplement?

The federal government standardizes Medicare Supplement plans, meaning benefits for each lettered plan are consistent across all insurance companies nationwide. Before you begin to research Medigap plans, though,  it is helpful to familiarize yourself with the Medigap pricing methods that carriers use. “Premiums vary among insurance companies, but the benefits of each standard Medigap plan are always the same. ” R. Morgan Griffin a writer at Web MD Explained.

Your carrier’s pricing method can affect the monthly premium rates of your Medigap plan, but not the benefits. R. Morgan Griffin continued, “for instance, a Medigap Plan C policy offers set benefits no matter which company you buy it from. However, standard Medigap policies are different in Massachusetts, Minnesota, and Wisconsin.”

 

Quote banner fro R. Morgan GriffinAdditionally, it is essential to note that if you have a Medicare Supplement policy and your spouse needs coverage, they must buy a separate policy.

Generally, Medicare Supplement plans offer individual coverage, so you and your spouse cannot share a policy. However, not being able to share a policy offers more positives than negatives for spouses. In this case, each spouse can obtain a plan to fit their unique health and budget goals.

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For example, Ronald and Carolyn are a married couple turning 65 and enrolling in Medicare. Ronald is very healthy and exercises every day. Carolyn was recently diagnosed with heart disease and had trouble walking up and down the stairs in their home.

When enrolling in a Medicare Supplement plan, Ronald wants something low-cost to cover him in an emergency. On the other hand, Carolyn needs to enroll in a plan that offers more comprehensive coverage, as she goes to the doctor at least once a month.

By having multiple Medigap insurance plans to choose from, both Ronald and Carolyn can receive better coverage while fitting their financial needs as well. Auditing your individual healthcare needs with a licensed Medicare agent can help you and your spouse enjoys personalized supplemental coverage that better fits your needs.

What is Medigap?

A Medigap plan is the exact same as a Medicare Supplement plan. Medigap is a shorter term for the formal name Medicare Supplement as these plans are known to fill the gap that Original Medicare leaves behind. Thus, the term Medigap was born.

If you hear someone talking about a Medigap plan, then you can automatically assume they are talking about one of the 12 standardized Medicare Supplement plans.

Can You Enroll in Medicare Supplement Plans at Any Time?

No, to be eligible for a Medicare Supplement (Medigap) plan, you must first enroll in Original Medicare. To qualify for Original Medicare, you must be a U.S. citizen or legal resident for at least five years and any of the following:

  • Age 65 or above
  • Collect Social Security Disability Income (SSDI) benefits for at least two years
  • Diagnosed with ESRD or ALS

After enrolling in Original Medicare, the best time to sign up is during your six-month Medicare Supplement Open Enrollment Period. This enrollment period begins on the first day of the month your Medicare Part B goes into effect.

When you enroll in a Medicare Supplement plan during this time, you have guaranteed issue rights. This means pre-existing conditions cannot affect your admittance to the plan. Carriers cannot decline your coverage based on your health history. You may still enroll in Medicare Supplements outside your Medigap Open Enrollment Period window, but you may be subject to health questions. During this time, you may be denied coverage due to pre-existing health conditions depending on medical underwriting.

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Being covered for the needs your healthcare requires is important, but you can’t underestimate the importance of finding the right coverage at the right price. Enrolling in the best Medicare Supplement plan the first time is key to saving yourself the most money in the long run.

How Much Does Medicare Supplemental (Medigap) Insurance Cost?

Medicare Supplement premium prices vary by ZIP Code and carrier. A policy of the same plan letter may cost more in one ZIP Code than another or from one carrier to the next. Depending on the option you choose, the average monthly premium can range between $40 and $300 and even more.

How much your Medigap insurance costs depend on several factors. Depending on your health and budget needs, one of these plans could save you from high unexpected medical costs. Although premium price is crucial when choosing a Medigap plan, it is not the only factor. You should also understand coverage and other out-of-pocket expenses.

When choosing a Medigap plan, it is essential to understand the carrier’s pricing method to determine the cost of your Medicare Supplement plan. There are three main pricing methods. Review them below:

  • Community-rated – Carriers who use community rating do not base rate increases on gender or age. Premium increases are the same across the board for anyone with a plan using the community-rating method.
  • Issue-age – Carriers who use issue-age rating base their premium on the age you are when you enroll in the plan. Your price will always be consistent with that of a person enrolling at the age you were when you signed up.
  • Attained age – Carriers who use attained age ratings will increase your premium based on your current age, regardless of how old you were when you enrolled in the plan.

Whichever pricing method your carrier uses, your Medicare Supplement plan’s premium will likely increase due to outside factors such as annual inflation. However, Medigap plans are often cheaper than forgoing supplemental benefits as they help cover rising healthcare costs you may face without the right coverage.

What Do Medicare Supplement Plans Cover?

Medicare Supplement plans cover all the same services as Original Medicare. Once Original Medicare pays its portion, those without a Medigap plan have a deductible, copayments, or coinsurance. However, you are no longer responsible for these out-of-pocket costs with Medicare Supplement plans.

Depending on your Medigap plan, your policy will cover most or all your leftover costs from Original Medicare. But it’s still important to compare Medicare Supplement plans to see what each lettered plan covers and what you will be responsible for paying.

These benefits include:

  • No network restrictions – you can see any doctor or visit any hospital that accepts Original Medicare
  • No requirement for referrals to see a specialist
  • Coverage is the same in all states
  • 12 unique plan options available to fit your healthcare needs and budget
  • Guaranteed renewable plans – your carrier cannot drop you for any reason other than not paying your premium
  • Medigap plans help reduce your out-of-pocket costs

If you are looking for a plan that prioritizes convenience and ease, a Medicare Supplement plan may be right for you. To review Medigap plan options, speak to a licensed Medicare agent to discover the best benefits for your needs.

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How Medicare Supplement Insurance Benefits Work

Difference Between Medicare Supplement Plan and Medigap Plan

If you are wondering what the differences are between a Medicare Supplement plan and a Medigap plan, you may be shocked to find out that they are the exact same type of insurance plan.

A Medigap plan and a Medicare Supplement plan are two names for one type of insurance coverage. Thus, the names are interchangeable. If you hear someone speaking about Medigap Plan G and Medicare Supplement Plan G, they are talking about the same coverage.

So, you may be wondering why there are two names for the same plan. This is because Medicare Supplement plans fill the gaps that Original Medicare coverage leaves behind. This is how we get the term Medigap, as in Original Medicare gaps. So, Medigap is merely a shortened version of the formal name, Medicare Supplement.

If you are trying to decide between enrolling in a Medigap plan or a Medicare Supplement plan, you already have the answer you are looking for. You do not need to decide between a Medicare Supplement and a Medigap policy because they are one and the same.

How Do Medicare Supplement Plans Work?

Medicare Supplement plans work by supplementing your Original Medicare benefits and providing you with more comprehensive healthcare coverage. Medigap plans aim to achieve a single goal: to lower the out-of-pocket costs for Medicare enrollees.

Once you enroll in a Medigap plan, you will have a better understanding of your annual out-of-pocket medical costs, reduce your risk for unexpected healthcare bills, and receive an overall higher level of Medicare insurance coverage.

Depending on the Medicare Supplement plan in which you enroll, you may be able to eliminate unexpected medical costs altogether, and because there are so many different options, there is a plan for everyone.

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The amount of care you receive each year will be the biggest determining factor as to which Medigap plan you should choose. In addition to predictable costs, you receive several additional benefits when you enroll in a Medicare Supplement plan.

Thus, Medicare Supplement plans are a great addition for anyone with Original Medicare. Speaking with a licensed Medicare agent can help you decide which Medigap benefits best suit your needs.

Can You Have Two Medicare Supplement Plans?

No, you cannot enroll in two Medicare Supplement plans. According to federal law, you can only enroll in one Medigap plan at a time. Thus, you should enroll in the best plan for your healthcare needs and budget.

Since Medicare Supplement plans will cover the gaps Original Medicare leaves behind, you may think that enrolling in multiple Medigap plans will save you more money in the long run. However, enrolling in two plans is not necessary.

Because enrolling in more than one Medicare Supplement plan at the same time is not legal in the United States, there are consequences that will cost you money and be detrimental to your healthcare. Not only would you be at risk for both plans saying the other is responsible for your coverage and receiving no coverage at all, but you would also risk being kicked off both Medigap plans.

Ultimately, you would lose your supplemental Medicare coverage and be responsible for the remaining 20% through Medicare Part A and Part B copayments, which can quickly add up.

What is the Most Popular Medicare Supplement (Medigap) Plan?

Due to their comprehensive coverage, Medigap Plan F, Plan G, and Plan N are the most popular Medicare Supplement plans nationwide. When conducting a Medicare Supplement plan comparison, you will notice that these best Medigap plans offer the most comprehensive coverage of the options available.

But while the most popular Medicare Supplement plan options attract more enrolled than others, benefits differ among all plans, and reviewing them carefully is important.

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Depending on your budget and healthcare needs, one of these three plans may work best for you. However, not all Medicare beneficiaries are eligible for all the top options. Those who received Medicare after January 1, 2020, are not eligible for Medicare Supplement Plan F. So if you are new to Medicare, your most comprehensive option is Medicare Supplement Plan G. Remember, the best Medigap plan is going to depend on your personal factors, regardless of the most popular options.

How Do Medicare Supplement Plans Work with Original Medicare?

 

Medicare Supplement plans work with Original Medicare by covering the costs left behind for beneficiaries to pay.

Once you enroll in Original Medicare, you become eligible for Medicare Supplement benefits. When you have Original Medicare, you do not have 100% coverage for Medicare-covered services. This leaves beneficiaries with out-of-pocket costs that can quickly add up.

To offset these costs, beneficiaries can enroll in Medigap plans. Once Original Medicare pays its portion of the bill, your plan will pay second. Depending on your plan, you may not pay anything out-of-pocket once you meet your plan’s deductible.

After factoring in your monthly premium, you will begin saving you money as early as your first doctor appointment of the year.

Which Medigap Policy Covers Services Not Covered by Original Medicare?

Medicare Supplement plans do not cover anything Original Medicare does not cover. Therefore, no Medigap plans cover anything that isn’t a Medicare-approved service.

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These plans are proper secondary coverage to Original Medicare. Thus, the plans only pay after Original Medicare pays its portion. Each Medicare Supplement plan covers a different percentage of costs.

For example, dental, vision, hearing, and prescription drugs are the most notable benefits that do not receive coverage.

However, when you enroll in a Medicare Supplement plan, you are not out of luck for these benefits. Beneficiaries often enroll in stand-alone dental, vision, and hearing plans and Medicare Part D prescription drug coverage alongside their Original Medicare and Medigap coverage.

How to Enroll in Medicare Supplement (Medigap) Plans

If you are eligible for Medicare benefits, Medigap plans can help you enjoy a more comprehensive form of coverage and get more out of your benefits. Call us at the number above to speak with a licensed Medicare agent who will help you compare your coverage options and identify the best benefits for your needs.

Not able to call? Don’t worry, we can still help. Simply complete our online rate form, and one of our agents will contact you with personalized quotes for affordable Medicare Supplement plans in your area.

Sources

MedicareFAQ is dedicated to providing you with authentic and trustworthy Medicare information. We have strict sourcing guidelines and work diligently to serve our readers with accurate and up-to-date content.

  1. When Can I Buy Medigap, Medicare. Accessed February 2022.
    https://www.medicare.gov/supplements-other-insurance/when-can-i-buy-medigap
  2. Medigap, Centers for Medicare and Medicaid Services. Accessed February 2022.
    https://www.cms.gov/medicare/health-drug-plans/medigap
  3. Medicare: What Are Medigap Plans?. Accessed December 2023.
    https://www.webmd.com/health-insurance/medigap
Jagger Esch

Jagger Esch

Medicare Educator
Jagger Esch is the Medicare Educator 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.
Ashlee Zareczny

Ashlee Zareczny

Compliance Manager
Ashlee Zareczny is the Compliance Manager for MedicareFAQ. As a licensed Medicare agent in all 50 states, she is dedicated to educating those eligible for Medicare by providing the necessary resources and tools. Additionally, Ashlee trains new and tenured Medicare agents on CMS compliance guidelines. Ashlee is a Medicare expert who specializes in Medicare Supplement, Medicare Advantage, and Medicare Part D education.

4 thoughts on "Medicare Supplement (Medigap) Plans"

  1. I have BCBS Medigap Plan F. The medical is 100% coverage of A and B. My problem is getting best Prescription, Dental, and Vision. My medicL is $208 monthly. Please advise!

    1. Hi Kristine – for prescription drug coverage to pair with your current coverage, you’ll need a Part D policy. You can also obtain bundled dental/vision/hearing coverage through an ancillary policy in addition. The costs for these plans vary by geographic area. To explore options, you can fill out our online rate form.

  2. we had Transamerica supplement insurance until 1/1/2021 and our agent said that medica would be a better insurance, and it is not. can he get back on the plan he had before?

    1. Hi Michael! Unfortunately, this is very common & beneficiaries end up learning the hard way. You can enroll in a Medigap plan at any time of the year. The only issue is if you have any pre-existing conditions you could be denied. Give us a call and we can help figure out how to get you back on the plan you had or equivalent.

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