by Russell Noga | Updated August 10th, 2023
Are you looking at enrolling in a Medigap plan? It’s a good move. With a Medicare supplement plan, you get coverage for the 20% of out-of-pocket expenses relating to the medical and hospital costs not covered by Original Medicare.
Medicare supplement plans, also known as “Medigap,” come in ten options, each offering a different level of coverage. People new to Medicare and Medigap often struggle with understanding the benefits, deductibles, copayments, and coinsurance responsibilities involved with these policies.
A licensed Medigap agent helps you navigate the plans to find the best option for your healthcare needs. But what do Medicare supplement advisors do?
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Why Do You Need Medicare Supplement Advisors?
A Medicare supplement advisor is a private company offering specialist advice on enrolling in Medigap plans. The Department of Insurance regulates these companies. Medigap advisors provide customized, free advice, consultations, and planning on joining a Medigap scheme.
You don’t pay anything for this service. Choosing a Medigap plan is confusing for many seniors. By using an advisor to help you navigate the Medigap range, you get the right insurance policy for your needs. You won’t end up over or under-insured.
For instance, the needs of a senior with chronic health issues are different from a healthy senior that rarely sees the doctor. In that case, the senior with chronic health conditions could benefit from the comprehensive coverage offered by Plan G.
The healthy senior might benefit from the lower premiums of Plan N but retain benefits in a medical emergency.
Find the Right Medigap Plan for You
Medigap plans come in ten options: Plans A, B, C, D, F, G, K, L, M, & N. Each plan has a different level of coverage, with the Federal government (CMS) regulating the industry. The CMS ensures all providers offer the same benefits in Medigap plans, standardizing the industry.
That means you get the same coverage in Plan G from Cigna as you do with Plan G from Humana, and so on. All Medigap plans offer the following benefits.
- Part A coinsurance and hospital costs for up to 365 days after using up Medicare benefits.
- Part A hospice care coinsurance or copayment.
- Part B coinsurance or copayment.
- Blood transfusion costs for the first three pints of blood.
Plans F*, G, and N offer additional Medicare Parts A & B benefits.
- Part A deductible.
- Part B excess charges (Plan N doesn’t cover these charges).
- Skilled nursing facility care coinsurance.
- 80% of emergency healthcare costs when traveling outside the US for 60 days. ($250 deductible and $50,000 maximum apply).
- Unlimited coverage for all out-of-pocket costs.
Medigap plans don’t pay for non-related medical costs not covered by Original Medicare Parts A & B. That means you don’t have coverage for expenses related to the following treatments.
- Private duty nursing and stays at nursing homes.
- Podiatry, Chiropractic, physiotherapy, acupuncture, etc. (However, if Medicare approves these treatments because they’re part of your hospitalization and rehabilitation, Medigap will cover the difference).
- Drug prescriptions.
- Vision, hearing, and dental services. (Some providers offer separate plans covering these services for an additional monthly premium. Other insurers offer discounted rates on these services if you use their in-network partners).
Save Time & Money – Get the Best Rates on Any Medigap Plan
The biggest issue with taking the task of enrolling in Medigap plans yourself is the premiums charged by the insurer. The premiums are the monthly contributions you make to remain part of the Medigap plan. Insurers must adhere to standardized Federal guidelines regarding the benefits offered in Medigap policies.
However, no Federal guidelines surround how much Medigap insurers can charge for monthly premiums. As a result, the cost of plans can vary widely between insurers and from state to state. For instance, UnitedHealthcare is the most affordable provider for a Plan G policy in Los Angeles. But the same plan might be more expensive for a company like Humana.
Likewise, UHC might be the cheapest provider for Plan G in Los Angeles, but they could be the most expensive option for Plan N. A Medigap advisor can source you the lowest rate in your state for any Medigap plan.
Some insurers offer add-on plans for dental, vision, and hearing services for an additional monthly premium. Or they might provide extra perks like discounts from in-network providers on hearing, vision, and dental services, OTC medications and supplements, gym memberships, and preventative care treatments.
For instance, Aetna is usually the lowest-cost provider for premiums in many states. However, the company has limited perks and additional benefits for members. Other providers like Cigna, UnitedHealthcare, and Humana offer excellent perks and competitive premiums. An advisor can help customize your coverage and perks to the right provider with the lowest premiums.
Understand Medigap Enrollment
Licensed Medigap agents can assist you with enrolling in a Medigap plan. The open enrollment period lasts six months from your 65th birthday, allowing you to enroll in a plan without undergoing medical underwriting. That means the insurer must accept your application to join their Medigap scheme, even if you have pre-existing health conditions.
However, you might want to switch plans if your financial or health situation changes. Medigap advisors can assist you with making the change at any time or during the annual enrollment period between October 15 and December 7 each year.
Using a Medigap advisor here at Medisupps.com gives you the best chance of avoiding medical underwriting when you decide to switch plans.
We can also assist with making the change from Medicare Advantage plans to Medigap.
We’ll help you enroll in Original Medicare and find the right insurer for your new Medigap policy in any state. Medigap advisors can assist you in finding out if you qualify for “special guaranteed issue rights,” where the insurer must treat your application like they do during the open enrollment period.
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Frequently Asked Questions
Why do you need Medicare Supplement advisors?
Call the Leading Medicare Supplement Advisors
Our team of fully licensed Medigap agents is ready to assist you with finding the right Medigap policy to suit your needs. Call us at 1-888-891-0229 for a free consultation and quote. We’ll walk you through the differences in the plans and secure the best rate on premiums for any plan from any provider in your state. If you can’t talk right now, leave your details on our contact form, and we’ll connect with 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.