What Are Medicare Supplement Plans?
Medicare Supplement plans, or Medigap, are an optional addition to Original Medicare, which includes Medicare Part A (hospital care) and Medicare Part B (medical care). These plans, offered by private insurers and approved by Medicare, are designed to help you cover out-of-pocket costs not covered by Medicare, such as copays, coinsurance, or deductibles.
There are 10 standardized Medigap plans, meaning each plan letter must have the same benefits. Working with an experienced insurance agent, such as the team behind Health Plus Life, can help you navigate your choices and make the best decisions for your healthcare needs.
Benefits of Choosing a Medicare Supplement Plan
For those who are covered by Original Medicare, also known as Medicare Part A and Medicare Part B, a Medicare Supplement plan can offer a cushion of protection against steep out-of-pocket costs for healthcare that aren’t covered by Medicare.
The primary goal of a Medigap plan is to enable beneficiaries to feel some sense of financial security, knowing they won’t be hit by potentially high costs for copayments or deductibles, for example. Because Medicare Supplement plans can help cover what Medicare won’t or can’t cover, they can be an option worth considering for those who already have Original Medicare.
Costs and Coverage of Medicare Supplement Plans
If you’re considering Medicare Supplement plan options, it’s worth getting to know the different coverage components you can expect. All Medigap plans cover the following:
- Part A coinsurance and hospital costs up to 365 days after Medicare benefits are used.
- Part B coinsurance or copay.
- Blood (3 pints).
- Part A hospice care coinsurance or copay.
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Some plans have additional coverage like skilled nursing facility care, deductibles, or out-of-pocket limits. Different plan letters have different benefits.
Learn more about the plans available in your state by chatting with a Health Plus Life agent.
If you’re looking for Medicare Supplement costs, you’ll want to work with our agents because the cost can vary widely. Here are the factors that will determine just how much a Medigap plan would be:
- The Plan: Medicare Supplement (Medigap) plans are standardized and identified by letters (A through N). Each plan provides a different level of coverage, so premiums will vary based on the plan you choose.
- The Insurance Company: Even for the same standardized coverage, the costs can vary among insurance companies. They may also have different discounts or pricing methods.
- Your Location: Where you live can affect the cost of your Medigap policy. Some states have higher average premiums than others.
- Your Age: Some policies price their premiums based on age. There are generally three ways insurance companies price Medigap policies: community-rated (same price regardless of age), issue-age-rated (price based on age when you buy), and attained-age-rated (price based on current age, going up as you age).
- When You Enroll: If you enroll during your Medigap open enrollment period (the six months starting the month you turn 65 and have Medicare Part B), the insurer can’t refuse to sell you any Medigap policy it offers, charge you more based on health conditions, or make you wait for coverage to start (except in some cases for pre-existing conditions). However, if you apply after this period, the insurance company can use medical underwriting, which could affect the cost and your acceptance into the plan.
The Enrollment Process for Medicare Supplement Plans
To be eligible for Medicare Supplement plans, someone needs to already be enrolled in Medicare Parts A and B. But it’s also worth keeping in mind that not everyone is eligible for Medigap — these additional policies aren’t compatible with Medicare Advantage (Medicare Part C) plans — so if you already have Medicare Advantage or want to switch to Medicare Advantage, Medicare Supplement plans aren’t for you.
If Medigap seems like a worthy addition to your Medicare Parts A and B coverage, the best time to enroll in a Medicare Supplement plan is during the Medigap Open Enrollment Period, a six-month window that begins the first day of the month you turn 65 or older and are enrolled in Medicare Part B. This is because during this short period of time, insurance companies are required to sell you any Medigap policy they offer regardless of any pre-existing health conditions at the same price as they would charge someone without those health conditions.
Medicare Supplement plans are provided by private health insurance companies, not the federal government, so you’ll want to call an expert team like Health Plus Life to consider options and enroll if Medigap is what you need.
Common Questions About Medicare Supplement Plans
What is a Medicare Supplement plan?
Medicare Supplement plans, often referred to as Medigap, are health insurance policies provided by private insurance companies. They are specifically designed to bridge the ‘gap’ by covering a number of out-of-pocket costs that are not covered by Original Medicare (Part A and Part B). These costs can include copayments, coinsurance, and deductibles, which can otherwise become significant financial burdens. The primary aim of these plans is to provide financial security and peace of mind to individuals using Medicare, ensuring they are not caught off guard by unexpected medical expenses.
How do I qualify for a Medicare Supplement plan?
To be eligible for a Medicare Supplement plan, you need to be enrolled in both Medicare Part A and Part B. It’s important to note that Medigap policies are designed to work in conjunction with Original Medicare; they are not compatible with Medicare Advantage plans. If you have a Medicare Advantage plan, you would need to switch back to Original Medicare before your Medigap policy begins in order to utilize a Medicare Supplement plan.
What is the best time to buy a Medicare Supplement plan?
The ideal time to purchase a Medigap policy is during your 6-month Medigap Open Enrollment Period. This period automatically begins on the first day of the month in which you turn 65 or older and are enrolled in Medicare Part B. During this window, insurance companies are required by law to sell you any Medigap policy they offer, regardless of any pre-existing health conditions, at the same price as they would charge a person in perfect health.
What does a Medicare Supplement plan cover?
Medicare Supplement plans are designed to help cover costs that are not paid by Original Medicare. Depending on the specific plan, this could include copayments, coinsurance, and deductibles associated with Medicare Part A and Part B. Some plans also provide coverage for medical emergency expenses during overseas travel, which are not typically covered by Original Medicare. However, it’s important to understand what Medigap policies generally don’t cover. This includes long-term care (like care in a nursing home), vision or dental care, hearing aids, eyeglasses, and private-duty nursing.
Do all Medicare Supplement plans offer the same benefits?
No, while all companies that sell Medicare Supplement plans must offer standardized policies — categorized by letters A through N — not all of these plans provide the same benefits. Each lettered plan offers a different level of coverage and benefits. Despite this, the specific benefits within each lettered plan are consistent across all insurance companies and states. This means, for instance, that a Plan G policy will offer the same benefits whether it is offered by Insurance Company A or B or whether you live in Texas or California.
Do Medicare Supplement plans cover prescription drugs?
Prescription drug coverage is an important part of healthcare, but as of 2006, Medicare Supplement plans sold to new beneficiaries are not allowed to include prescription drug coverage. If you’re looking for coverage for your medications, you can join a Medicare Prescription Drug Plan (Part D). These plans are offered by private insurance companies approved by Medicare and can be used in conjunction with Original Medicare and a Medigap policy to help cover your health costs.
Can I have a Medicare Supplement plan and a Medicare Advantage plan at the same time?
No, it’s not possible, and actually, it’s against the law for someone to sell you a Medigap policy if you have a Medicare Advantage Plan. The two types of coverage are not designed to work together. Medigap policies are meant to supplement Original Medicare, while Medicare Advantage Plans are an alternate way to get your Medicare coverage. If you have a Medicare Advantage Plan but want to switch back to Original Medicare and purchase a Medigap policy, you can do so, but it’s important to navigate this transition carefully to ensure you don’t have a lapse in coverage.
Where can I find more information about Medicare Supplement plans?
If you need more comprehensive information about Medicare Supplement plans, you can visit the official Medicare website, www.medicare.gov. This website offers a wealth of information about the ins and outs of Medicare, including Medigap policies. You can also call the toll-free number for Medicare, 1-800-MEDICARE (1-800-633-4227), to speak directly with a knowledgeable representative who can answer your questions and provide additional guidance.