by Russell Noga | Updated July 9th, 2023
Original Medicare serves nearly 35 million Americans, with 10,000 people in the country turning 65 every day. Medicare Parts A & B help seniors and retirees deal with the burgeoning costs of healthcare, assisting them with receiving the care and treatments they need to live a healthy lifestyle in their senior years.
Despite Original Medicare being a saving grace for many Americans’ finances, it doesn’t cover everything. Original Medicare pays for around 80% of inpatient and outpatient healthcare costs.
The beneficiary must settle the remaining 20% of their medical expenses. Medigap plans cover this 20% gap left by Original Medicare, giving seniors and retirees more predictability in their annual healthcare expenses.
There are ten Medigap plans, eight active and two (Plans F & C) only available to beneficiaries eligible for Medicare before January 1, 2020.
How do Medicare supplement plans work? What coverage do you get with a plan, and what do they cost?
Speak to the Experts About Enrolling in a Medigap Plan
If you have questions about Medigap plans, get advice from professionals. Call us at 1-888-891-0229 to speak to one of our fully licensed experts about finding a plan that suits your healthcare needs.
We have an online quote engine on our site assisting you with estimating premiums for the plan you want to take.
Or fill out the contact form, and we’ll have someone call you back for a free consultation to discuss your Medigap Requirements.
How Do Medicare Supplement Plans Work?
Medigap plans will fill the gaps left in your healthcare expenses by Original Medicare. Each offers varying levels of coverage, with a premium reflecting the benefits it provides.
The top-end plans F & G, offer near-comprehensive cover, while the lower-end plans, K & L, bring you bare-bones coverage.
Premiums for plans are obviously higher for the more comprehensive plans and lower for those on the bottom end of the scale. If you need help wrapping your head around the coverage and costs of Medigap plans, call us, and we’ll walk you through them.
What are the Key Benefits of Medigap Supplement Plans?
Every Medigap plan comes with standardized benefits set by Federal regulations. That means every private insurer selling Medigap must provide beneficiaries the same level of benefits.
As a result, there’s consistency across coverage in Medigap throughout the industry.
- Covers the shortfalls in expenses left by Medicare Parts A & B.
- No healthcare provider networks. Visit any medical practitioner accepting Medicare nationwide.
- Portable coverage following you overseas to cover you for foreign travel emergencies.
- Predictable costs with set premiums paid monthly.
- Guaranteed renewable policies and your benefits don’t change.
- Non-cancellable if you continue to pay premiums.
- The ability to switch plans whenever you want during the year.
- No Annual enrollment requires you to sign up every year.
- Standardized Plans offer the same benefits on policies across all industry providers.
Here’s what you can expect from the benefits offered by Medigap (Plans may vary in the coverage they provide, with the following benefits not available for all plans. Speak to us for more information).
- Medicare Part A deductible.
- Medicare Part A coinsurance hospice care and hospital costs.
- Medicare Part B coinsurance and copayment for doctor visits and outpatient services.
- The first three pints of blood in transfusions.
- Skilled nursing facility care coinsurance.
- Up to 80% of medical costs incurred during foreign travel, provided you meet the $250 deductible.
Some plans, such as Plan G & F, cover the Part B excess charges from medical providers charging more than Medicare-approved rates. Other plans, like Plan N, require you to make copayments on these expenses.
Plan F is the only plan covering the Part B deductible of $226. However, it’s only available to people eligible for Medicare before January 1, 2020.
If you want the best level of coverage for new members, Plan G is near-comprehensive, but you’ll have to pay the Part B deductible. Still, the savings you make on Plan G premiums over Plan F will likely cover this deductible amount.
Plans, like Plan N, come with low monthly premiums, but copays of $20 on doctors’ visits and copays of $50 on visits to the emergency room that don’t end up with you being admitted to the hospital for care.
Plans G & F are also available in high-deductible versions, where your Part A deductible increases from $1,600 to $2,700, but you have a much lower monthly premium.
High-deductible Plan F & G aren’t available in all states, so you’ll need assistance finding out if any providers offer it in your area.
Contact us for more advice, and we’ll walk you through the best Plan options to meet your healthcare requirements.
What Do Medigap Plans Not Cover?
All Medigap plans provide coverage for inpatient and outpatient healthcare costs Original Medicare doesn’t cover.
However, they don’t cover you for preventive care, hearing, dental, and vision treatments, and your prescriptions.
Some providers offer extensions to their plans that cover these costs but for an additional fee.
Understanding Medigap Plan Premiums
Private Medical insurers, like Cigna and Humana, offer Medigap plans to beneficiaries across the United States. However, not all insurers operate in all states.
Providers set your premiums based on your age, with some using an issue-rated model where your age doesn’t count toward your premium, while others use an attained-age rating where your age plays a factor in the premium cost.
Your gender and smoking status also play a role in your premium cost, with men being more expensive to sure and nonsmokers receiving lower rates than a smoker. The biggest influence on your premiums comes from your location in the United States.
Insurers offer plans at different rates in different states. For instance, Mutual of Omaha might be the least expensive provider for Plan G in 2024 in one state but the lowest-cost provider in another. Conversely, Cigna might offer Plan G for one price in a state and sell the same policy for more or less in another state.
That’s why you need a professional broker to assist you with finding the best rate for your prospective plans premium in your area.
Our team will help you get the lowest rate and the best discounts from providers in your state.
Medicare Supplement Plans in 2024
While Medigap plans are not changing for 2024 in terms of benefits, the rates might change for each company. Our FREE online quote engine can help you see rates in your area and determine if you’re paying too much. Or call us today at 1-888-891-0229 to get your questions answered by one of our licensed insurance agents.
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Frequently Asked Questions
What are Medicare supplement plans, and how do they work?
Medicare supplement plans, also known as Medigap plans, are private health insurance policies designed to supplement Original Medicare coverage. These plans help cover out-of-pocket costs such as deductibles, coinsurance, and copayments that Medicare alone may not fully cover.
Who is eligible for Medicare supplement plans?
To be eligible for a Medicare supplement plan, you must be enrolled in both Medicare Part A and Part B. You need to be at least 65 years old or have a qualifying disability. It’s important to note that Medicare supplement plans do not work with Medicare Advantage plans.
How do Medicare supplement plans differ from Original Medicare?
Original Medicare is provided by the federal government and includes Part A (hospital insurance) and Part B (medical insurance). Medicare supplement plans are private insurance policies that help fill the gaps in coverage left by Original Medicare. These plans are sold by private insurance companies and can offer additional benefits and coverage options.
What benefits do Medicare supplement plans typically cover?
Medicare supplement plans may cover various benefits, depending on the plan you choose. Some common benefits include coverage for Medicare Part A and Part B deductibles, coinsurance, and copayments. Certain plans may also cover additional services such as foreign travel emergency care or excess charges.
Can I choose any doctor or hospital with a Medicare supplement plan?
Yes, with a Medicare supplement plan, you can generally visit any doctor or hospital that accepts Medicare patients. These plans provide you with the freedom to see any healthcare provider who participates in the Medicare program.
How do I enroll in a Medicare supplement plan?
To enroll in a Medicare supplement plan, you must first be enrolled in Medicare Part A and Part B. Then, you can choose a plan from the available options in your area. It’s advisable to compare plans and prices from different insurance companies to find the one that best meets your needs.
Are Medicare supplement plans renewable?
Yes, Medicare supplement plans are guaranteed renewable. As long as you pay your premiums on time, the insurance company cannot cancel your coverage, regardless of any changes to your health status. This provides you with long-term coverage and peace of mind.
Can I switch Medicare supplement plans?
Yes, you can switch Medicare supplement plans at any time. However, it’s important to note that you may be subject to medical underwriting if you switch plans outside of your initial enrollment period. During the initial enrollment period, you have guaranteed issue rights, which means insurance companies cannot deny you coverage or charge higher premiums based on pre-existing conditions.
Do Medicare supplement plans cover prescription drugs?
No, Medicare supplement plans do not cover prescription drugs. If you want prescription drug coverage, you need to enroll in a separate Medicare Part D prescription drug plan. These plans are also offered by private insurance companies and can be added to your Medicare supplement coverage.
How do I compare Medicare supplement plans?
To compare Medicare supplement plans, you can use online resources or consult with a licensed insurance agent. Consider factors such as the plan’s coverage, premiums, reputation of the insurance company, and customer reviews. It’s important to choose a plan that aligns with your healthcare needs and budget.
Find the Right Medicare Plan for You
Finding the right Medicare plan shouldn’t have to be confusing. Whether it’s a Medigap plan, or you have questions about Medicare Advantage or Medicare Part D, we can help.
Call us today at 1-888-891-0229 and one of our knowledgeable, licensed insurance agents will be happy to assist you!
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.