Medicare Supplement Plans (Medigap)
Medicare Supplement plans cover 11 million Medicare beneficiaries. Also referred to as Medigap plans, these policies help pay for your share of Medicare expenses, such as your deductibles and co-insurance. Medicare supplement insurance plans are available for purchase in all 50 states and are very popular with people who want little to no copays when they access healthcare services. Many people new to Medicare feel surprised to find that Medicare covers only 80% of your Part B expenses. The other 20% can be devastating to you financially if a serious illness arises. You can choose a Medicare Supplement that will pay some or all of that 20% for you, among other things. Supplemental insurance for seniors with Medicare essentially buys you peace of mind by eliminating that cost-sharing responsibility.
Medicare Part B only covers 80% of your medical expenses. Medicare Supplement (Medigap) plans help pick up the excess costs.
Also, during your one-time open enrollment window, you are guaranteed the right to purchase a Medicare Supplement plan. Your health status does not matter when you buy a plan during this six-month window.
What is a Medicare
Supplement
A Medicare Supplement also called a Medigap Policy fills in the gaps in your coverage that is left over after original medicare pays their share.
Because you are required to pay for some things, like 20% of outpatient expenses, medigap policies were created to pay those expenses for you. Folks on medicare supplements don’t stress out about a big bill or thousands coinsurance, deductibles, or any surprises that might blindside them.
Some of the primary advantages of a traditional Medicare Supplement policy are:
- Freedom to choose your own doctors and hospitals
- No referrals are required to see a specialist
- Predictable out-of-pocket expenses for Medicare-covered services
(and zero out-of-pocket with Plan F) - Nationwide coverage – you can use it anywhere in the United States
- Guaranteed renewability – the insurance company can never drop you or change your coverage due to a health condition
Supplemental insurance for seniors with Medicare is easiest and most predictable way to budget healthcare costs. Seniors on popular medicare supplement plan G pay a monthly premium upfront but on the back end the only costs they’ll have are the $226 annual Part B deductible.
Some other things to know about Medicare Supplement insurance:
You must have Part A and Part B to buy a Medigap policy. Medicare Supplement plans cover only one person. Your spouse must have his or her own individual policy. You can drop your supplement at any time. There is no annual election period for Medicare Supplement plans. The Annual Election Period in the fall is for drug plans. It does not apply to Medicare supplements in any way. Many carriers offer household discounts if two or more people enroll in Medicare supplemental plans from the same company Plans do not include Part D, so you’ll add a separate standalone Part D drug plan.
Medicare Supplemental Plans Coverage
Medicare Supplement plans pay after Medicare approves and pays its share of your claim. Medigap insurance, helps to cover the gaps in Medicare that normally you would have to pay. This includes things like deductibles, coinsurance and copays.
You can use your Medicare Supplement plan at any provider in the nation that accepts Medicare. This makes Medicare Supplements great for snowbirds or seniors traveling to visit grandkids.
Medicare Supplements plans do not include retail drug coverage, so we advise strongly you enroll in a standalone Part D drug plan for your medications even if you don’t take any, because there is a lifetime penalty added to your monthly premium waiting for you down the road if you don’t enroll in drug plan during your initial enrollment period. A Medicare Supplement does not cover routine, dental, vision or hearing services either. Since Medicare itself does not cover these items, your supplement cannot pay anything toward them either.
Medicare Supplements Plans – Standardized Plans
To see a list of all the Medicare supplemental plans available take a look at our Medigap supplement chart above. This chart appears in the “Choosing a Medigap,” booklet published by Medicare itself. It details the benefits covered by each different plan.
*Medigap Plan F and Plan G are also offered as a high-deductible plan (HDF or HDG) by some insurance companies in some states. If you choose the high-deductible option, it means you must pay for Medicare-covered costs (coinsurance, copayments, deductibles) up to the deductible amount of $2700 in 2023 before your policy will pay anything.
***Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission. You can find this chart in Medicare’s Choosing a Medigap booklet as well.
What are the different Medicare Supplements Plans?
Each Medicare Supplement plan in the chart above has a letter, A – N. Each plan letter provides a different set of benefits. However, each lettered plan must have the same standardized coverage regardless of which insurance company you choose. For example, Medicare Supplement Plan N at Blue Cross Blue Shield has the same benefits as Plan N from United Healthcare.
The Medicare Supplement chart below shows the 10 standardized Medicare Supplement plans. These plans can be offered by insurance companies in most states. Wisconsin, Minnesota and Massachusetts have different options though.
There is one supplemental insurance plan that covers ALL OF the gaps, leaving you with nothing out of pocket, Plan F. There are others where you agree to do some cost-sharing and in return, you get a lower monthly premium. If you prefer something like this, in the middle, you could look at Plans G or N where you pay a few things yourself, in exchange for lower premiums.
How do I pick a Medicare Supplement plan?
Most people enroll in Medicare Supplement Plans F, G or N. That’s because these offer the most coverage. However, the reason for the choices is to let you decide what is most important to you. Some beneficiaries want a plan that covers all the gaps and leaves them with no worries about the cost of medical procedures. Other beneficiaries prefer a Medicare supplement plan in which they cover some of their deductibles and copays out of pocket in order to achieve lower premiums. There is no right or wrong here.
Ask the agent you decide to work with to provide quotes for several plans and see what offers the most long-term value
Watch Video Below on How to Choose a Medicare Supplement
Medicare Supplemental Plans – Open Enrollment
The government’s Medicare’s Guide to Health Insurance tells us the best time to buy a supplement policy is during your one-time open-enrollment window. This window begins on the first day of your birth month or the month that you enroll in Part B. It lasts for six months and is a “use it or lose it” enrollment period. During your one-time Medigap Open Enrollment, the Medicare supplement company cannot ask you any medical questions. They cannot turn you down for any health conditions. They cannot refuse you a policy or charge you any additional amount due to health conditions, medications or pre-existing Illnesses. You will have your choice of Medicare supplemental plans.
After this window passes, however, and you decide to enroll in a medicare supplement with any of the companies, they can decline you for certain health conditions or particular medications you take that are on the companies decline list. That is why the medicare and you book states that open enrollment is the best time to enroll.
Please note: the Annual Election Period in the fall is NOT a time when you can change Medigap plans with no health questions. Many people mistakenly believe this. The Annual Election Period in the fall pertains to your Part D plan, not your Medigap plan.
Medicare Supplement Plans – Guaranteed Issue
Some people delay enrollment into a supplement because they have group health coverage through an employer. Later when you retire or lose that coverage, you have the right to purchase certain Medigap policies within the 63 days following the loss of your group coverage. This is called your Medicare supplement guaranteed issue rights.
The guaranteed issue window works just like open enrollment, except that is a shorter period of time and that your plan choices are limited to Plans A, B, C, F, K, and L (if you became eligible for Medicare prior to 2020). If you become eligible for Medicare in or after 2020, your GI plan options are A, B, D, G, K, and L. The insurance company cannot deny your application for any health reasons.
There are some other circumstances that create a guaranteed issue window as well, such as losing Medicare Advantage coverage when moving out of state. Guaranteed issue rules can vary by state, so be sure to check with a licensed agent who can inform you about the laws that apply in your state. Our agency is licensed in 38 states, so feel free to contact us if you would like for us to check for you.
You will want to keep any notices from your prior carrier that show proof of your creditable coverage for guaranteed issue and also so that you do not incur the Part D late enrollment penalty.
Medicare Supplement Plans- Underwritten
If your window has already passed for open enrollment or guaranteed issue, you can still apply for a Medicare supplement, but you will have to answer some health questions on your application. The insurance company can accept or decline you.
What happens if you miss Open Enrollment?
Some people are confused by this because they believe the Annual Drug Election Period in the fall is a time when they can change their supplement without underwriting. Unfortunately, the autumn election period only applies to drug plans and Medicare Advantage plans. Changing Medigap carriers will require underwriting in most cases.
What is the Best Medicare Supplemental plan?
Medicare Supplemental Plan F is currently the plan with the highest level of coverage. It pays for all of your Medicare cost-sharing, leaving you with nothing out-of-pocket on covered services. You can buy a Medicare supplement from a variety of different insurance companies. However, plans of the same letter are standardized so that the benefits are the same. A Medicare Supplement Plan F with one company has the same benefits as the next company.
Medicare Supplemental Plan G is the next most comprehensive plan. It works exactly like Plan F except that you pay for the Part B deductible once per year. Your premiums will be lower though, and sometimes this creates annual savings. To find the best Medicare supplemental plan in your area, contact us for a free report that includes quotes and rate trend histories. Since there are several standardized plans available to you in each state, you will want to think carefully about which one fits your needs the best.
Common Questions about Medicare Supplemental Insurance
What is the average cost of supplemental insurance for Medicare?
Pricing for Medicare supplement policies varies by state. In some states like Florida, the premiums are higher because the cost of healthcare services in that area is higher. For example, we might be able to find a Plan G for a turning-65 female non-tobacco user for around $80 /month in South Carolina while the same policy would cost more than twice that in Florida.
Most Medicare supplement companies also base their rates on gender, zip code, tobacco usage, and age. Some individuals may also benefit from household discounts. For quotes in your own zip code, give us a call at 843-227-6725.
What is the open enrollment period for Medicare supplemental plans?
When people first activate Medicare Part B, they have 6 months to enroll in any Medicare Supplement without health questions. The insurance company will approve your application with no pre-existing condition waiting period. We call this the Medicare Supplement Open Enrollment Period. It is a one-time window.
Be aware that the Annual Election Period (AEP) that occurs each fall is NOT a time when you can get a Medicare supplemental insurance plan with no health questions asked. The AEP has nothing to do with Medigap plans. Instead, it’s a time when you can change your Part D drug plan.
Can you change Medicare supplements anytime?
You can apply to change your Medicare Supplement at any time, but if you are past your Open Enrollment window, you will have to answer health questions in most states.
Can you change Medicare supplements anytime?
You can apply to change your Medicare Supplement at any time, but if you are past your Open Enrollment window, you will have to answer health questions in most states.
The Medicare supplement carrier will review your health history and medication history. They can accept or decline you.
There are a few states where the rules are different. For example, California, Oregon, Connecticut and Washington have established exceptions to this rule and states like NY, MA, and VT (there’s a few more) but some states don’t require underwriting and you can enroll anytime of year you want and be accepted guaranteed.
What is the guaranteed issue for Medicare supplemental insurance?
In certain circumstances, an insurance company must accept you for coverage without asking health questions. For example, if you are on Medicaid and you lose your Medicaid eligibility, you have a short window to apply for Medigap without health questions.
Another example would be for someone coming off employer health coverage that is primary to Medicare. They will have a short window to apply for certain Medigap plans under guaranteed issue rules.
Do I really need supplemental insurance with Medicare?
Supplemental is optional. However, without any supplemental insurance, you would be responsible for expensive hospital deductibles and copays as well as 20% of the cost of ALL outpatient services. This includes things like surgeries and chemotherapy which would be financially devastating without some form of supplemental coverage.
If you find that a Medicare Supplement is out of your budget, then you should consider a Medicare Advantage plan, which has lower premiums because you agree to use a network of providers in your local area.
Find the Right Medicare Supplemental Insurance
When you buy your coverage directly from an insurance company, you give up a lot of benefits. Purchasing through May River Medicare costs exactly the same, but we provide these FREE value-added services for our policyholders.
Fill out Form Below to Generate Your own quote from every carrier in your zip code that offers Medicare Supplements with Rates and Carriers
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Watch Video on why Plan N offers more value than the Plan G
Plan N
•One small deductible of $226 for 2023
•Low Co-pay $0-20 for Doctor Visit (average $14 per visit) no copay for physical therapy and $50 ER
Whether you are new to Medicare and looking for the right Medicare Supplement plan to fit your needs, or you’ve been on Medicare a few years and are trying to keep up to date with the best coverage, you should absolutely consider Medicare Plan N as an option.
Medicare Supplement Plan N in 2023
Without a doubt, Medicare plan N will be one of the most popular Medigap Plans for 2023 with more enrollments than ever.
Medicare Supplement Plan N has:
•Lower Premiums than Medicare Plan G
•Lower Rate increase than Plan G
•No Network (Choose the best doctors)
•Great coverage, minimal out-of-pocket expenses
Medicare Plan N – Great Coverage
Medicare Plan N is currently the 2nd most enrolled-in Medigap Plan. Only Plan G has more policyholders, as it pays almost 100% of the gaps (expenses) in Medicare Part A and B.
Medicare Plan N vs Plan G
When it comes to deciding if Plan N or Plan G would be a better option for you, it really comes down to just a few variables.
Medicare Plan G
When it comes to deciding if Plan N or Plan G would be a better option for you, it really comes down to just a few variables
If you’re the type of person who wants as few medical bills as possible, and you’re willing to pay extra for that luxury, then Plan G is absolutely the way to go.
Medicare Supplement Plan G Pros:
•100% coverage after you pay just one small deductible (Annual Part B – $226 in 2023)
•No co-pays, coinsurance, or any other deductibles to pay
•Relatively low premiums
Medicare Part B Excess Charges
Doctors in this country who accept Medicare, also accept the assigned rates that Medicare publishes. This simply means that Medicare provides the doctors with the amounts they can charge.
This is called “assignment”.
Doctors must choose to either accept Medicare assignment for their entire practice or not. If a doctor does not accept Medicare assignment, they may charge up to 15% above what the Medicare rate is. With Medicare Plan N, you are required to pay this 15%.
Plan N does not cover Part B excess charges, but not to worry. It’s estimated that 96% of all doctors in the country accept Medicare assignment, so it’s quite rare that you would ever see an excess charge.
In fact, a study was done by a major carrier recently and it was determined that less than 1% of all their health claims actually had a Part B excess charge. And even in those few cases, the charge was less than $20.
To find out if your doctor accepts the assigned rates, just click below
Plan N versus Plan G Video (Why N is better than G)
Click Image Below to Get Your Free Plan G versus Plan N Comparision
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