Medicare Supplement Plans in Illinois

Summary: Medicare Supplement (Medigap) plans in Illinois are standardized to provide the same benefits as Medigap plans nationwide. Each plan offers different benefits based on your needs. Estimated Read Time: 10 min

Table of Contents:

1. Best Medicare Supplement Plans in Illinois
2. Eligibility for Medicare Supplement Plans in Illinois
3. How Much Do Medicare Supplement Plans in Illinois Cost?
4. Medicare Supplement Plan Carriers in Illinois
5. Medigap Plans in Illinois for Disabled Persons Under 65
6. Medigap Rating Methods In Illinois
7. Medigap Guaranteed Issue Protections in Illinois
8. When to Enroll in Medicare Supplement Plans in Illinois
9. What is the Illinois Birthday Rule?
10. Additional Medicare Coverage Options in Illinois

Medicare Supplement plans in Illinois follow federally standardized rules, so they are the same as in most other states. When you enroll in Original Medicare, you can also get a Medicare Supplement (Medigap) plan, which will pay secondary to cover what Original Medicare doesn’t. It is essential to research the Medigap plans and carriers available in your area to ensure you enroll in the best coverage possible.

Below, we review what makes Illinois unique when it comes to Medicare Supplement plans. We also help explain how best to utilize the benefits of Medigap plans in Illinois.

Best Medicare Supplement Plans in Illinois

Medicare Supplement plans cover the gaps between what Original Medicare pays and what it leaves for the beneficiary to pay out-of-pocket. These policies pay secondary to Original Medicare to offset your financial responsibility.

When you enroll in Medigap, you keep all the same benefits of Original Medicare. You can see any doctor who accepts Original Medicare – meaning almost all practitioners in the United States.

Medicare Supplement Plan F in Illinois

Medigap Plan F in Illinois was once the King of Medicare Supplement plans because it covers every cost after Original Medicare pays. However, many Medicare beneficiaries are no longer eligible to enroll in this coverage. Specifically, those initially eligible for Original Medicare after January 1, 2020, cannot enroll in Medigap Plan F.

Additionally, Medicare Supplement Plan F has declined in popularity, even among those eligible to enroll. This decrease in enrollment is due to high premium increases on Medigap Plan F, which negates the annual savings that come with the plan’s coverage of the Medicare Part B deductible. Thus, it is more cost-effective for most to enroll in Medicare Supplement Plan G.

Medicare Supplement Plan G in Illinois

Medigap Plan G in Illinois is swiftly becoming the most popular Medicare Supplement plan available. This plan covers everything Medicare Supplement Plan F covers, other than the Medicare Part B deductible. Thus, once you meet the annual Medicare Part B deductible, your policy will cover you 100% for the rest of the calendar year.

Medicare Supplement Plan N in Illinois

Medigap Plan N rounds out our list of best Medicare Supplement plans in Illinois. This plan is a fantastic option for the Medicare beneficiary who does not want to pay a high monthly premium but still wants to ensure coverage in an emergency.

With Medicare Supplement Plan N, you are responsible for covering the Medicare Part B deductible and $20-$50 copayments when visiting the doctor or emergency room. Additionally, you may be subject to excess charges.

Excess charges are an additional 15% cost on top of the pre-determined price of medical services Medicare covers if the beneficiary receives the services from a doctor who does not accept Medicare assignment. Eight states do not allow excess charges. However, Illinois is not one of those states.

Ultimately, the best Medicare Supplement plan for you is the one that brings you the most value. So, if you do not visit the doctor regularly and your family health history is not concerning, Medicare Supplement Plan N could save you quite a bit of money. Still, if you are eligible and want top-of-the-line coverage, you may be partial to Medicare Supplement Plan F.

Eligibility for Medicare Supplement Plans in Illinois

To be eligible for a Medigap plan in Illinois under normal circumstances, you must be 65 or older, and you must be enrolled in both Medicare Part A and Medicare Part B.

Furthermore, you cannot have an existing Medicare Advantage (Part C) plan if you want to enroll in a Medigap plan. Medigap plans cannot be used in conjunction with Medicare Advantage plans. You must first disenroll from your Medicare Advantage plan before you can apply for a Medigap policy.

How Much Do Medicare Supplement Plans in Illinois Cost?

The cost of Medicare Supplement plans in Illinois is based on factors specific to the beneficiary. Premium factors fluctuate based on carrier, but age, sex, ZIP Code, and tobacco-use status are the most common. How you answer each question will directly affect your monthly premium cost.

Below is an example of a male and female who enroll in a Medicare Supplement plan in Illinois (Zip 60131). In both scenarios, the beneficiary does NOT use any form of tobacco. Remember that these prices are examples, and your actual cost could be more or less than the below rates.

Medicare Supplement Plan Carriers in Illinois

Some of the most popular Medicare Supplement insurance companies in Illinois are:

• Aetna
• Cigna
• Humana
• UnitedHealthCare
• Mutual of Omaha

When considering your coverage options, it is crucial to thoroughly examine the available choices, as costs can differ among different companies. While it is important to compare premiums when selecting a Medicare Supplement plan, it is not the sole factor to consider when choosing a provider.

Independent credit agencies like S&P or A.M. Best assess the financial stability of carriers, offering valuable insights as to whether they have the proper funds to cover all of your medical needs. Moreover, consumer agencies such as the Better Business Bureau (BBB) evaluate the overall customer experience with these insurance companies.

Medigap Plans in Illinois for Disabled Persons Under 65

Since the 1980s, Illinois requires Medicare Supplement plan carriers to sell at least one Medigap plan to those who qualify for Medicare under age 65. However, there is no federal mandate for carriers to offer all plans to beneficiaries under 65.

When you enroll in a Medigap plan in Illinois under age 65, you will likely pay a higher premium than those who are over 65. This is because you will likely be subject to medical underwriting, which means that the insurance company can consider your health status and may charge higher premiums or deny coverage based on pre-existing conditions.

Therefore, you receive a second Open Enrollment Period upon turning 65. This opportunity allows beneficiaries to choose a new plan with a potentially lower premium.

Medigap Rating Methods in Illinois

In Illinois, most Medicare supplement plans are issued using a rating method called attained age to determine premiums.

Under the attained-age rating method, premiums for Medigap plans are based on your current age. The premiums typically start lower when you first enroll in the plan and increase as you get older. The increase in premiums is usually due to the associated higher healthcare costs, as individuals tend to use more medical services as they age.

Insurance companies in Illinois may also use two other rating methods to set premiums for Medigap plans, and they are the community-rating and the issue-age rating.

With the community-rating method, everyone enrolled in the same Medigap plan in a particular geographic area pays the same premium, regardless of age. The premium may increase over time due to inflation and other factors but not based on age.

Under the Issue-age rating method, the premium is based on your age at the time of enrollment. The premium is generally lower for those who enroll at a younger age and will not increase solely due to age. However, the premium may increase due to inflation or other factors.

It’s important to note that the rating method affects the premiums you pay for your Medigap plan, but it does not impact the standardized benefits offered by each plan. Medigap plans are standardized across the United States, so the coverage for a specific plan (e.g., Plan G, Plan N) is the same regardless of the insurance company offering it.

Medigap Guaranteed Issue Protections in Illinois

Federal law requires Medigap plans to offer certain guaranteed issue protections that ensure you can enroll in a plan without being denied coverage or charged higher premiums due to pre-existing conditions. These protections are designed to provide access to Medigap coverage when you need it.

One important guaranteed issue right is your Medicare Advantage trial period. If you initially enrolled in a Medicare Advantage (Part C) plan when you first became eligible for Medicare and within the first year of joining, you decide to disenroll from that Medicare Advantage plan, you have a one-time guaranteed issue right to enroll in a Medigap plan instead. This allows you to obtain Medigap coverage without medical underwriting.

Other rights include protections for losing coverage. If you lose employer-based retirement coverage, or if you’re enrolled in a Medigap plan that terminates, discontinues, or is no longer offered in your area, you have a guaranteed issue right to enroll in another Medigap plan. You must apply for a new Medigap plan within 63 days of the termination of your existing plan to qualify for this protection.

Lastly, you also have Medicare Advantage-based guaranteed issue rights. If you are enrolled in a Medicare Advantage plan, and your plan is terminated, you move out of the plan’s service area, or you lose your coverage due to reasons beyond your control, you have a guaranteed issue right to enroll in a Medigap plan. You must apply for a Medigap plan within 63 days of the termination of your Medicare Advantage plan to be eligible.

When to Enroll in Medicare Supplement Plans in Illinois

The best time to enroll in a Medigap plan is during the six-month open enrollment period, which starts on the first day of the month in which you turn 65 and are enrolled in Medicare Part B.

During this period, insurance companies are required to offer you a Medigap plan without considering pre-existing conditions. However, after this period ends, insurance companies can subject you to medical underwriting. This means they may review your medical history and health status to determine your eligibility and set premiums.

The insurance company would then take your health into account and may charge you higher premiums or deny coverage based on your medical history, especially if you have any pre-existing conditions.

So even though, technically, you can enroll for a Medigap plan any time after you turn 65, it’s best for you and your wallet to do so during your open enrollment period.

What is the Illinois Birthday Rule?

As of January 2022, Illinois implemented a birthday rule for Medicare Supplement plans. The rule allows Medicare Supplement beneficiaries ages 65 to 75 to change to a lesser or equal benefit plan with the same carrier.

This change must occur during a window starting on your birthday and lasting 45 days. The Illinois birthday rule aims to provide a chance for individuals to enroll in a new plan when they may otherwise be denied entry due to pre-existing health conditions.

Additional Medicare Coverage Options in Illinois

Medicare Supplement plans in Illinois are not the only form of coverage available for those over 65. One of the most significant holes in Original Medicare and Medicare Supplement plans is the lack of prescription drug coverage as well as dental, vision, and hearing coverage. These services are necessary to maintain a healthy lifestyle.

If you enroll in a Medicare Supplement plan in Illinois, you should also sign up for a Medicare Part D plan as soon as possible. Medicare Part D plans work alongside Original Medicare to provide coverage for prescription drugs.

Additionally, several carriers offer stand-alone dental, vision, and hearing plans that combine the benefits of these services into one policy. While Medicare eligibility does not factor into eligibility for these plans, they are most helpful for those with Original Medicare.

If you wish to enroll in coverage with a low to zero-dollar monthly premium, a Medicare Advantage plan might be right for you. Medicare Advantage plans bundle Original Medicare and additional benefits into an all-in-one plan.

However, since Medicare Advantage becomes your primary source of coverage, it often restricts beneficiaries to small networks of physicians with additional restrictions on coverage. These plans can also ultimately have higher out-of-pocket costs per year in comparison to Medigap.

It is illegal to enroll in both a Medicare Supplement and a Medicare Advantage plan. So, it is important to research both plan types before deciding which coverage to choose.

How to Apply for a Medicare Supplement Plan in Illinois

You can apply for Medicare Supplement plans over the phone with a knowledgeable agent. At MedicareFAQ, we are not only an excellent resource for Medicare education, but we also work one-on-one with our clients to find theright plan for their needs. You do not need an Illinois-based agent to find your ideal coverage.

Our agents provide every client with a personalized plan comparison outlining the top options based on your healthcare needs. Our agents can help to provide you with all the education and options available so that you can determine the coverage suitable for your needs & budget. We can also help walk you through the application process to ensure all information is received correctly.

You deserve the best policy with the excellent customer service, and we deliver just that! Give us a call at the number above to get your rates today. Or, fill out an online rate form to see your rates now!

Enter ZIP Code

Enter your ZIP code to pull plan options available in your area.

Compare Plans

Select which Medicare plans you would like to compare in your area.

Get Quote

Compare rates side by side with plans & carriers available in your area.