Medicare Supplements were created to supplement benefits. Only 80% of your medical expenses have coverage after deductibles.
Supplemental plans fill in the gap between Medicare’s payments and the actual amount. These gaps include co-pays, deductibles, and coinsurance.
With many policy options, the best Medicare Supplement for you depends on the level of coverage you need.
Below we’ll review:
- Eligibility guidelines
- Enrollment Periods
- How benefits work
- Available Supplement Plans
- Important facts
- How to apply
Eligibility Guidelines for Medicare Supplements
To be eligible for a Supplement Plan, you must be at least 65 years of age and have Part B. These plans are also available to those on Medicare due to a disability, but not in all states.
Enrollment Periods for Medigap Plans
You can enroll in a Medigap Plan at any time during the year, as long as your Part B is in effect.
Upon your enrollment in Part B, your Medicare Supplement Open Enrollment Period (OEP) will start. This window only happens once and can’t be changed.
Your OEP is six months long. During this period, you can buy Supplement insurance with Guaranteed Issue (GI).
After this six month period, you’ll no longer have GI, but you can still enroll.
However, without GI you’ll have to answer medical questions that could impact your approval 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.
How Medicare Supplement Insurance Benefits Work
Supplement coverage is 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 plan covers basic benefits, starting with Plan A, and adds further levels of coverage.
This way, everyone can get the personal healthcare benefits necessary to cover out of pocket costs. It’s important to note that these plans only cover one individual.
If your spouse needs coverage, they must buy a separate policy.
Benefits All Medicare Supplement Plans Will Include
- Remaining 20% of your Part B medical costs left over after Medicare pays
- Coverage for Part A coinsurance and hospital costs up to an additional 365 days after benefits
- Part B coinsurance and co-payments
- Any hospice care coinsurance and co-payments
- First 3 pints of blood
Benefits Some Medicare Supplement Insurance Plans Will Include
- Part A deductible
- Part B deductible
- Excess charges
- Foreign travel emergency
- Coinsurance for skilled nursing facility care
What Medicare Supplement Plans Do Not Cover
- Routine vision care
- Routing dental care
- Prescription drugs
- Private-duty nursing
- Long Term Care
- Hearing Aids
List of Medicare Supplement Plans
The plans are listed in order from most popular to least popular:
- Plan F is a first-dollar coverage plan that leaves you with $0 out of pocket costs.
- High-Deductible Plan F covers the same benefits as Plan F. The difference is it requires you to meet the deductible before any coverage starts.
- Plan G is the second most popular plan, as it covers almost all benefits. It comes with a much lower premium than Plan F.
- High-Deductible Plan G covers just like Plan G. The main difference is the deductible is met before coverage begins.
- Plan N has low premiums compared to other plans. It requires a small co-payment for some office and hospital visits.
- Plan C is also a first-dollar coverage plan. The only out of pocket cost you’re responsible for is excess charges. Don’t confuse Plan C with Part C, they’re two different plans.
- Plan D is extensive as well and covers everything except for the Part B deductible and excess charges. Don’t confuse Plan D with Part D, they’re also two different Plans.
- Plan K is a cost-sharing plan. It pays half of your out of pocket co-insurance costs.
- Plan L is also a cost-sharing plan. It pays 75% of your out of pocket co-insurance costs.
- Plan M provides extensive coverage, similar to Plan G. Except it only covers half of your Part A deductible for hospitalization.
- Plan A helps fill in the gaps with co-payments, deductibles, and coinsurance, but includes the least amount of benefits.
- Plan B will cover all the same benefits Plan A does, in addition, it will cover your Part A deductible.
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
- Supplements do NOT include coverage for drugs. You would enroll in a Part D plan to cover your drug costs.
- Policies only give coverage to the policyholder. If you want coverage for your spouse or family member, they need to buy their own policy.
- It’s only available for people who have both Part A and Part B.
- By law, policies must be renewable even for people with health conditions. In other words, you can never lose your policy as long as you pay your premiums.
- Policy premiums are in addition to any Part B premiums.
- You cannot enroll in a Supplement Plan if you have an Advantage Plan.
- It’s illegal to sell someone a policy if they have a Medical Savings Account (MSA) plan.
- All first-dollar coverage plans will be discontinued for all beneficiaries who become Medicare eligible after 2020.
- Depending on where you live, you may be eligible to buy a certain kind of policy called Medicare SELECT. These SELECT policies provide a built-in escape clause to allow you to change your policy within the first year with no penalties.
What Companies Sell Medicare Supplements
Don’t Confuse These Types of Coverage for Medigap Plans
- Veterans’ benefits (VA)
- Tribal and/or Indian Health Service coverage
- Part D
- State-level aid
- Medicare Advantage Plans (including HMOs, PPOs, and fee-for-service plans)
- Long-term care insurance
- Employer/union plans, including FEHBP (Federal Employees Health Benefits Program)
Medicare Supplements Costs
It’s important to note that prices and premiums vary by the insurance company, as well as by state. The same plan may cost more in one state than another. Depending on the letter plan you choose, the average premium can range between $50-$300.
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 by another company.
Beneficiaries should take their time when selecting a policy.
Get Rates for Medigap Plans Online or By Phone
Plans vary by state, talking to an expert who can help you find affordable Medicare Supplement Plans in your area will give you peace of mind.
Our representatives will help you compare rates with the top carriers in your area to find a plan that fits your unique healthcare needs and budget.
Give us a call today. If you prefer to compare rates online, you can complete our rate comparison form.