by Russell Noga | Updated November 6th, 2023
While Medicare Part A and Part B (Original Medicare cover a lot, it doesn’t cover everything. In fact, it only covers 80 percent of your expenses, and it doesn’t pay for certain things, like copays, coinsurance, and deductibles.
You’re responsible for the costs that Original Medicare doesn’t cover, and those out-of-pocket expenses can get pretty pricey.
That’s where a Medicare Supplemental Insurance plan can come in handy, as these policies help to cover the expenses that aren’t covered by Part A or Part B.
There are 10 Medicare Supplemental Insurance plans, and each plan offers different benefits.
If you’re thinking about purchasing this insurance, it’s important to choose a plan that will provide you with the coverage you require.
The best way to do that is by considering your health and the benefits that each plan provides, as well as the cost of coverage.
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What is Medicare Supplemental Insurance?
Medicare Supplemental Insurance, also known as Medigap, is additional insurance that is designed to cover the out-of-pocket expenses that aren’t covered by Original Medicare (Part A and Part B).
These plans are sold by private health insurance companies and they’re regulated by the federal government.
There are 10 different Medigap plans, which are named for letters, and the benefits that each lettered plan provides vary.
However, the same lettered plans – Plan F or Plan G, for example – must provide the same coverage, no matter where they are purchased or which insurer they are purchased from.
It is important to note that Medicare Supplemental Insurance is not a replacement for Medicare Part A and Part B, but rather it supplements both parts of Original Medicare.
In other words, it works alongside Original Medicare. The benefits your plan offers will kick in after Original Medicare has paid its share.
What Does Medicare Supplemental Insurance Cover?
As stated above, there are 10 Medicare Supplemental Insurance plans: A, B, C, D, F, G, K, L, M, and N. Individuals who became eligible for Original Medicare after January 1, 2020 can no longer purchase Plans C, F, E, H, I, and J.
However, if you had one of these plans before this date you can retain it and the benefits will be accepted, and if you were eligible for Medicare before this date but haven’t yet enrolled, you may still be able to purchase Plans C and F.
Most of the Medicare Supplemental Insurance plans will cover all or at least a part of the following expenses:
- Part A coinsurance and hospital expense for up to 365 days after your Part A benefits have been used up
- Part A hospice coinsurance and copayments
- Part B coinsurance or copayments
- The first three pints of blood required for medical procedures
On top of these benefits, some Medicare Supplemental Insurance policies will also cover the following expenses:
- Part A deductible
- Part B deductible
- Part B excess charges
- Skilled nursing facility expenses
- The cost of emergency care you require when you’re traveling outside of the United States, as long as the care is received within the first 60 days of your trip
What Medicare Supplemental Insurance Doesn’t Cover
Medicare Supplemental Insurance doesn’t cover the following expenses:
- Prescription drugs
- Vision care, including prescription eyeglasses
- Dental care
- Hearing care, including hearing aids
While Medigap plans cannot provide this coverage, some health insurance companies provide their policyholders with additional perks. These perks may include coverage for the above-mentioned expenses that Medicare Supplemental Insurance plans won’t cover.
How to Choose a Medicare Supplemental Plan
All Medicare Supplemental Insurance plans are standardized. This means that all lettered plans must offer the same benefits, no matter which company they’re purchased from or which state they’re purchased from.
For example, whether you purchase Plan N in California or Texas, and whether you purchase coverage from Mutual of Omaha or AARP/United Healthcare, that plan must provide the same standard benefits.
It is important to remember, however, that some Medicare Supplemental Insurance plans cover more of the out-of-pocket expenses that aren’t covered by Original Medicare; Plan G, for example, provides more coverage than Plan A.
Also, the cost varies from policy to policy. Medigap policies that offer more coverage tend to cost more than those that provide less coverage.
There are other factors that can affect pricing, as well; for example:
- which insurer you purchase coverage from (private health insurance companies set their own rates),
- where you purchase coverage (in states where the cost of living is higher, Medigap prices tend to be higher),
- your gender (females live longer than males, on average, so their rates are usually lower),
- and inflation are just some of the factors that can impact pricing.
With that said, in order to decide which Medicare Supplemental Insurance plan to choose, you’ll want to consider your health, as well as your budget.
If you’re generally healthy and you don’t need to go to see doctors regularly, Plan N may be the right option for you, as the premiums are lower; however, this plan doesn’t cover copays, so you will need to pay those.
Since this plan provides the most benefits, if you see doctors on a regular basis, Plan G will be more cost-effective for you because it covers more of the out-of-pocket expenses that aren’t covered by Part A and Part B.
Once you’ve determined which Medigap plan will best suit your healthcare needs, you should then compare prices from different insurance companies.
Keep in mind, however, that you should also pay attention to customer reviews; insurers that charge lower rates may provide a lower degree of customer care, while a company that charges higher rates may offer stellar service.
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Russell Noga is the CEO of Medisupps.com, an online Medicare Agency and resource center helping Medicare beneficiaries learn about Medicare, Medigap and Part D drug plans, and Medicare Advantage plans since 2009. Russell is licensed in all 50 states and has been featured as a keynote speaker, and author of several publications, along with hosting the very popular Medisupps.com Youtube channel.