by Russell Noga | Updated April 21st, 2024
If you recently turned 65 and became eligible for Medicare coverage, there’s no doubt you’ve received a ton of information about Medicare Supplement Insurance. These plans cover some of the expenses that Original Medicare (Part A and Part B) doesn’t cover and can be a real lifesaver, as they can help to make the cost of your healthcare more predictable and manageable. There are several types of Medicare Supplement Insurance plans, and several insurance companies provide these policies.
To help you make the best decision for your healthcare needs, in this guide, we provide more information about Medicare Supplement Insurance, including how it works, the different options that are available, and the benefits that it provides.
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Medicare Supplement Insurance Explained
Medicare Supplement Insurance, which is also referred to as Medigap, is a supplemental insurance that works in conjunction with Original Medicare (Part A and Part B). Original Medicare covers 80 percent of your medical care, and you are responsible for the remaining 20 percent.
You have two options when it comes to paying that remaining 20 percent: you can either pay it out of your own pocket, or you can purchase a Medicare Supplement Insurance plan. These plans are separate from Original Medicare and have their own premiums. As long as you keep up with the premiums, the coverage that a Medicare Supplement plan provides will kick in once your Original Medicare benefits have been exhausted. These plans are sold by private insurance companies.
There are 10 different Medigap policies, which are named for capital letters. All policies cover the cost of things like copayments, coinsurance, and deductibles that Original Medicare doesn’t pay for; however, some policies cover more out-of-pocket expenses than others. All Medigap plans are standardized, which means that all policies of the same letter must offer the same coverage, regardless of where they’re purchased or which provider they’re purchased from; for instance, whether you purchase Plan A in Virginia or Kansas, your policy must offer the same benefits that Medicare has approved for Plan A, no matter which insurance company you purchase Plan A from.
Types of Medicare Insurance Supplement Plans
As mentioned, there are a total of 10 Medicare Supplement Insurance plans; however, new Medicare beneficiaries are no longer able to buy some of these plans. As of January 1, 2020, changes were made to Medicare that prevented those who became eligible for the government-funded insurance. As per these changes, no Medigap policy can cover the cost of the Part B deductible. Plans C, F, E, H, I, and J are no longer available to new beneficiaries; however, if you had one of these plans before the start of January 2020, you can keep your policy. Additionally, if you were eligible for Medicare before the start of January 2020 but have not yet enrolled in the program, you may still be able to purchase Plan C and Plan F.
What Do Medicare Supplement Insurance Plans Cover?
All Medicare Supplement Insurance plans are required to cover at least some, if not all of the following expenses:
- Part A coinsurance and hospital expenses
- Part A hospice care coinsurance and copayments
- Part B coinsurance or copayments
- Up to the first three pints of blood transfusions that are required for medical procedures
In addition to these standard benefits that Medicare requires for all Medigap policies, some plans also offer coverage for the following out-of-pocket expenses:
- Part A deductible
- Part B deductible
- Part B excess charges
- Skilled nursing facility expenses
- Emergency care deemed medically necessary while traveling outside the US
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What Isn’t Covered by Medicare Supplement Insurance?
Medicare Supplement Insurance policies are designed to supplement Part A and Part B of Original Medicare; these policies aren’t additional coverage, and they don’t replace Original Medicare. While these plans do help to cover some of the out-of-pocket expenses that Medicare Part A and Part B don’t cover – and while some plans offer more benefits than others – no Medigap policy will cover the following expenses:
- Prescription drugs
- Vision care
- Prescription eyeglasses
- Dental care
- Hearing care
- Hearing aids
Who is Eligible for Medicare Supplement Insurance?
In order to qualify for Medicare Supplement Insurance, you will need to have both Part A and Part B of Original Medicare. Typically, this includes people who are aged 65 and older or individuals who have been diagnosed with qualifying disabilities. If you have Medicare Advantage (also referred to as Medicare Part C), you are not eligible for Medicare Supplement Insurance. If you have a Medicare Advantage plan and you would like to enroll in Medigap insurance, you will first need to drop your current Medicare Advantage plan and enroll in Original Medicare, which you can do during the enrollment period.
How Much Do Medicare Supplement Insurance Plans Cost?
The costs for Medicare Supplement Insurance plans vary and depend on a variety of factors. Private insurers set the rates for the premiums they offer, and can use one of the following “ratings” when setting prices:
- Community-rated. With community-rated policies, the same monthly premiums are charged, no matter your age.
- Issue-age-rated. Premiums are based on your age when you purchase a Medigap plan. Typically, the older you are, the less expensive the policy will be.
- Attained-age-rated. With this rating, premiums depend on your age and the older you are, the higher your premium will be.
In addition to these factors, the following factors can also influence the cost of premiums:
- Your location
- Your gender
- Inflation
- Your health (depend on when you purchase coverage)
When Can You Enroll in Medicare Supplement Insurance?
The best time to enroll in Medicare Supplement Insurance is during the open enrollment period. This period starts on the first day of the month you turn 65 and you’re enrolled in Part B. The period lasts for 6 months. During the open enrollment period, your application cannot be subjected to insurance underwriting; that is, insurance companies cannot take your medical history or your current health status into consideration when assessing your application, or when setting the rates.
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Frequently Asked Questions
What is Medicare Supplement Health Insurance?
Find the Best Medicare Supplement Insurance Rates
Medigap can be a real lifesaver, as it can help to make your healthcare costs more predictable and manageable. When shopping for Medicare Supplement Insurance, it’s important to compare rates for different plans from different insurers. To receive and compare quotes from multiple reputable insurers, submit the form to the right or give us a call directly at 1-888-891-0229 and we’ll be happy to assist you with your needs!
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.