by Russell Noga | Updated September 5th, 2023
Whether you’re new to Medicare, or you’re already enrolled in Original Medicare Part A & Medicare Part B, you qualify for a Medicare Supplement policy (Medigap). But if you already have Medicare, why would you want a Medigap Plan?
Well, the reality is that while Medicare is vital in reducing your annual healthcare expenses, it doesn’t cover you for everything.
Medicare only covers a portion of Medicare Part A (hospital) coverage, and 80% of Medicare Part B (Doctor’s services) costs. It’s up to you to pay the remaining 20% of the expenses left behind by Medicare, along with various deductibles, copays, and coinsurance.
This article covers Medicare supplement plans cost, benefits, and options. We’ll give you everything you need to know to make an informed decision on the right plan for you.
You can even view the rates in your area for the most popular Medicare Supplement plans right here on our website with no obligation.
What are the Different Types of Medicare Supplement Plans?
Each of the ten Medigap plans available from insurers in 2024 comes with a standardized level of benefits regulated by the Federal government.
That means every insurer offers the same benefits in each plan, bringing consistency to the industry.
Here are the benefits you can expect with Medigap plans.
All 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.
Plan F, G, and N Offer the following additional benefits for Medicare Parts A & B
- 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.
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How Do Medicare Supplement Plan Providers Set Premiums?
Plan Benefits
The benefits offered in each plan are a determining factor in the premiums charged to the policyholder.
The more coverage you have, the more expensive your policy is. However, that might not always be the case.
For instance, the high-deductible versions of Plans F & G offer excellent coverage in emergencies but require a higher annual deductible (moving from $1,600 for the standard plan to $2,700 for the HD plan).
In exchange, you get a much lower monthly premium, saving as much as 60% to 70% off the standard Plan G or F premium.
Medicare Plan N also offers good coverage for seniors in medical emergencies, with lower monthly premiums. However, you must make copayments at the doctor’s office and emergency room.
Age-attained
Some insurers will charge attained-age or related-age premiums depending on your age.
So, they might lock you into a premium for life or increase the premium as you age. Typically, premiums increase with age and adjust to economic factors like inflation.
Attained-Age-Related-Policies
This premium is based on your current age.
Your policy premium will increase as you get older.
Issue-Age-Rated Policies
The insurer bases your premium on your age when you purchase your Medigap policy.
Younger seniors will receive lower prices, and the premiums don’t increase as you get older, other than for economic reasons, like inflation.
Community-Rated or No-age-rated
This model starts all applicants at the same premium, regardless of age.
Gender & Smoking
Plans can also vary in cost depending on your personal risk profile.
Men and smokers are more expensive to insure because they tend to experience more medical complications as they age compared with women and nonsmokers.
Women usually pay around $10-$15 less in monthly premiums. Smokers could end up paying as much as $100 or more above the rate charged to nonsmokers.
Location
Medigap premiums vary between states and providers. Some providers are more expensive than others in some states and cheaper in others.
For example, Aetna might be the most affordable option for Plan G in one state but the most expensive option in another.
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Medicare Supplement Plans Cost – Analyzing Average Premium Costs
So, what can you expect to pay for a Medigap policy? Here are the average costs of Medigap policies across all states in America.
Note: These prices are across age groups from 65 to 75 years and include smokers, nonsmokers, men, and women. They also represent the average premium costs across all insurers.
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- Medigap Plan A – $85 to $416
- Medigap Plan B – $113 to $303
- Medigap Plan D – $106 to $340
- Medigap Plan G – $96 to $341
- HD Medigap Plan G – $30 to $67
- Medigap Plan K – $47 to $112
- Medigap Plan L – $59 to $250
- Medigap Plan M – $72 to $274
- Medigap Plan N – $72 to $310
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Frequently Asked Questions
What are Medicare Supplement Plans?
Medicare Supplement Plans, also known as Medigap plans, are private insurance policies designed to help cover the gaps in Medicare Part A and Part B coverage. They provide additional benefits such as copayments, deductibles, and coinsurance, which can help reduce out-of-pocket expenses for healthcare services.
How much do Medicare Supplement Plans cost?
The cost of Medicare Supplement Plans can vary depending on several factors, including the insurance company, the plan type, the location, and the age of the individual. Premiums can range from around $50 to $300 per month. It’s important to compare prices and coverage options before choosing a plan.
What are the benefits of Medicare Supplement Plans?
Medicare Supplement Plans offer various benefits, including coverage for Medicare Part A and Medicare Part B deductibles, copayments, and coinsurance. Some plans may also cover services not covered by Original Medicare, such as emergency care during foreign travel, and Medicare Part B excess charges.
Can I choose any doctor or hospital with a Medicare Supplement Plan?
Yes, in most cases, you can choose any doctor or hospital that accepts Medicare patients. Medicare Supplement Plans do not have restricted networks, allowing you the freedom to see any healthcare provider who accepts Medicare.
Are prescription drugs covered by Medicare Supplement Plans?
No, Medicare Supplement Plans do not cover prescription drugs. To obtain coverage for prescription medications, you will need to enroll in a separate Medicare Part D Prescription Drug Plan.
Can I switch Medicare Supplement Plans at any time?
While you can apply for a Medicare Supplement Plan at any time, it’s important to note that there are certain periods, such as the Medigap Open Enrollment Period, which is the six-month period starting from the month you turn 65 and are enrolled in Medicare Part B, during which you have guaranteed issue rights. Outside of these periods, you may be subject to medical underwriting, which could affect your ability to switch plans.
Do Medicare Supplement Plans cover long-term care?
No, Medicare Supplement Plans do not cover long-term care, such as nursing home care. They primarily focus on covering costs related to hospital stays, medical procedures, and doctor visits.
Are there any restrictions on pre-existing conditions with Medicare Supplement Plans?
During the Medigap Open Enrollment Period, insurance companies are generally not allowed to deny coverage or charge higher premiums based on pre-existing conditions. However, if you apply for a Medicare Supplement Plan outside of this period, insurance companies may consider your pre-existing conditions and could charge higher premiums or deny coverage.
Can I have a Medicare Supplement Plan and a Medicare Advantage Plan at the same time?
No, it is not possible to have both a Medicare Supplement Plan and a Medicare Advantage Plan simultaneously. These two types of plans cannot be used together to supplement your Medicare coverage.
Are Medicare Supplement Plans standardized?
Yes, Medicare Supplement Plans are standardized and regulated by the federal government. This means that each plan type, labeled with a letter (e.g., Plan F, Plan G), offers the same basic benefits regardless of the insurance company selling it. However, costs and availability may vary among insurance providers.
Find the Right Medicare Plan for You
Finding the right Medicare plan doesn’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.
Contact 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 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.