by Russell Noga | Updated January 7th, 2024
Medicare, a health insurance program that is funded by the federal government via taxpayer dollars, provides coverage for individuals who are aged 65 and older, as well as individuals who have been diagnosed with qualifying medical conditions and disabilities. Medicare consists of several parts, and Part A and Part B combined are known as Original Medicare.
While Original Medicare does cover a lot of the expenses that are related to healthcare, there are gaps in coverage that beneficiaries are responsible for paying. These out-of-pocket expenses can be exorbitant and for many, can cause financial hardship. That’s where Medicare Supplement Insurance can help, as this coverage is designed to help fill in the gaps in Medicare coverage.
But does Medicare Supplement Insurance cover all of the expenses that Original Medicare doesn’t include? More specifically, does it cover the Part B deductible? The short answer to this question is: it depends. For a more detailed explanation of Medicare Supplement Insurance and the Part B deductible, keep on reading.
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An Introduction to Medicare Supplement Insurance
As mentioned, Medicare is a government-sponsored health insurance program that consists of several parts. Part A and Part B combined are known as Original Medicare.
Part A covers the cost of care and services that are received in inpatient settings, such as short-term hospital stays and hospice care, and Part B covers the cost of care and services that are received in outpatient settings, such as doctor appointments, preventative care, and durable medical equipment.
While it’s true that Part A and Part B will cover a lot of your healthcare needs, it won’t cover everything; for example, it doesn’t provide coverage for deductibles, copays, and coinsurance. That’s where Medicare Supplement Insurance can help.
Also known as Medigap, Medicare Supplement Insurance is, as the name suggests, separate health insurance that is designed to supplement Original Medicare; in other words, it covers some of the costs that aren’t included in Part A and Part B, such as deductibles, copays, and coinsurance.
There are several Medicare Supplement Insurance plans, which are labeled with letters. All plans are sold by private insurance companies and offer standard benefits that are required by the federal government. That is, all lettered plans must include the same benefits, no matter which insurance company they’re provided by, or where they are purchased.
What Does Medicare Supplement Insurance Cover?
The costs that Medicare Supplement Insurance covers vary from plan to plan. Some policies offer more coverage than others; however, all Medigap policies cover all or at least a percentage of the following expenses that Original Medicare doesn’t include:
- Part A coinsurance and hospital expense
- Part B coinsurance or copays
- Part A coinsurance or copays for hospice care
- The first 3 pints of blood required for medically-necessary blood transfusions
Some Medigap plans also offer coverage for the following expenses that Original Medicare doesn’t include:
- Part A deductible
- Part B deductible
- Part B excess charges
- Skilled nursing facility care
- Emergency care while traveling outside of the United States
What is the Part B Deductible?
The Part B deductible refers to the portion of Original Medicare – Part B – that pays for outpatient medical care and services; doctor visits, preventative care, and durable medical equipment, for example. Part B has an annual deductible, which is the portion that you have to pay out-of-pocket, before Medicare kicks in and covers the rest.
The cost of the Part B deductible changes on a yearly basis; in 2023, for instance, the rate was $226. This means that if you had Original Medicare in 2023 and you had an appointment with your doctor for a check-up, you would have to pay $226 before your Medicare coverage kicked in.
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Does Medigap Cover the Part B Deductible?
Whether or not Medicare Supplement Insurance will cover the cost of the Part B deductible depends. As can be seen by the information presented above, some Medigap plans do offer coverage for the Part B deductible. Medigap policies that provide coverage for the Part B deductible include Plans C and F. If you have one of these plans, rather than having to pay the Part B deductible when you receive outpatient medical care or services out of your own pocket, your insurer will pay the expense for you.
It is important to note, however, Plan C and Plan F are not available to all Medicare beneficiaries. Due to changes in Medicare, anyone who became eligible for Original Medicare after January 1, 2020, can no longer purchase any Medigap policy that includes coverage for the Part B deductible. Individuals who were enrolled in Medicare before this date and had one of these policies can keep it and the benefits will still be honored, and individuals who became eligible for Medicare before January 1, 2020, but have not yet enrolled, can still purchase one of these policies.
What Insurance Companies Offer Medicare Supplement Plan C and Plan F?
If you were eligible for Medicare before January 1, 2020, you haven’t yet enrolled in the health insurance program but you intend to, and you would like to purchase a Medigap policy that covers the Part B deductible, you can purchase either Medigap Plan C or Plan F. Like all Medicare Supplement Insurance policies, Plans C and Plan F are sold by private insurance companies. There are several companies that offer both of these policies. The following are just some of the insurers that provide these policies:
- Aetna
- Anthem Blue Cross Blue Shield
- Bankers Fidelity
- Blue Cross Blue Shield
- Central States Indemnity
- Cigna
- Continental Life Insurance
- Humana
- Mutual of Omaha
- Oxford Life
- United Healthcare
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Frequently Asked Questions
Does Medigap Cover Part B Deductible?
Yes, some Medigap plans provide coverage for the Medicare Part B deductible. Medigap Plans C and F used to offer this coverage, but they are no longer available to new enrollees. However, if you already have Medigap Plans C or F, you can keep your coverage, including the Part B deductible coverage.
Who is eligible for Medigap Plans?
To be eligible for Medigap plans, individuals must be enrolled in Medicare Part A and Part B. The best time to enroll is during the Medigap Open Enrollment Period, which lasts for six months and begins when you are 65 or older and enrolled in Medicare Part B. During this period, you have guaranteed issue rights, meaning insurance companies cannot deny you coverage or charge you more based on pre-existing conditions.
When can you enroll in Medigap Plans?
The Medigap Open Enrollment Period is the ideal time to enroll in a Medigap plan, as you have guaranteed access to coverage without medical underwriting. After this period, you can still enroll in Medigap plans, but insurers may consider your health status, and premiums could be higher.
What are the best Medicare Supplement plans?
The best Medicare Supplement plans for you depend on your individual healthcare needs and budget. Plan G and Plan N are popular choices due to their comprehensive coverage and competitive pricing.
What does Medicare Supplement Plan G cover?
Medicare Supplement Plan G covers most of the gaps in Original Medicare, including Part A and Part B coinsurance, hospice care coinsurance, and the first three pints of blood. It also covers skilled nursing facility care coinsurance and 80% of foreign travel emergency costs.
What does Medicare Supplement Plan N cover?
Medicare Supplement Plan N provides similar coverage to Plan G but requires beneficiaries to pay certain cost-sharing amounts, such as a copayment for doctor’s visits and emergency room visits. It does not cover the Part B deductible or Part B excess charges.
What is the difference between Medicare Supplement Plans and Medicare Advantage?
Medicare Supplement plans work alongside Original Medicare and help pay for out-of-pocket expenses not covered by Medicare. Beneficiaries can see any healthcare provider that accepts Medicare.
Medicare Advantage plans, also known as Medicare Part C, are private health insurance plans that replace Original Medicare. They often include prescription drug coverage and may offer additional benefits like dental and vision. However, beneficiaries may need to use a network of providers and follow plan rules.
How does Medigap cover the Part B deductible?
Medigap Plans C and F used to cover the Medicare Part B deductible. If you enrolled in either of these plans before they were closed to new enrollees, your plan will continue to cover the Part B deductible.
How to choose between Medigap Plans and Medicare Advantage?
When choosing between Medigap plans and Medicare Advantage, consider your healthcare needs, budget, preferred providers, and prescription drug coverage requirements. If you want more flexibility in provider choice and additional benefits, a Medicare Advantage plan might be a better fit. If you prefer the freedom to see any provider without referrals and want more predictable out-of-pocket costs, a Medigap plan could be a suitable option.
Can you have both Medigap and Medicare Advantage plans?
No, you cannot have both Medigap and Medicare Advantage plans simultaneously. If you have a Medigap plan, you cannot enroll in a Medicare Advantage plan, and vice versa. You can choose either one based on your preferences and healthcare needs.
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If you have questions about Medicare Supplement plans, call our team at 1-888-891-0229. We offer professional advice on Medigap policies. Our fully licensed agents offer free consultations to give you all the information you need about Medigap. If you want someone to call you back, leave your details on our contact form, and we’ll get a Medigap expert to reach out to you.
Russell Noga is the CEO and Medicare editor of Medisupps.com. His 15 years of experience in the Medicare insurance market includes being a licensed Medicare insurance broker in all 50 states. He is frequently featured as a featured as a keynote Medicare event speaker, has authored hundreds of Medicare content pages, and hosts the very popular Medisupps.com Medicare Youtube channel. His expertise includes Medicare, Medigap insurance, Medicare Advantage plans, and Medicare Part D.