by Russell Noga | Updated August 31st, 2023
There are 10 different Medigap plans. If you want more coverage than what’s offered by Original Medicare Part A & Medicare Part B, you’ll need a Medigap policy to take care of the healthcare expenses you incur.
What are the top 10 Medicare supplement plans, and how do they differ?
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We’ll walk you through the differences in the plans and help you choose the right one for your healthcare requirements.
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What Does Medigap Insurance Cover?
So, what does Medigap cover? Every plan offers the following core benefits to beneficiaries.
- Cover for the Part A Hospital copayment ($400 per day for days 61-90, $800 per day after day 90 for 2023)
- Pays for an extra 365 days of hospital care after Medicare benefits expire.
- Pays Part B the copayment (typically, 20% of the Medicare-approved amount).
You’ll pay part of the cost-sharing involved in some covered services until you meet your annual out-of-pocket limit. Plan K has a $6,220 out-of-pocket limit, and Plan L has a $3,110 out-of-pocket limit.
After meeting the limit, your Medigap policy pays all Medicare coinsurance, copayments, and deductibles for the rest of the year.
Here’s a breakdown of the rest of the benefits offered by Medigap plans.
Part A Deductible
The amount Medicare doesn’t pay for inpatient hospital stays per benefit period ($1,600 in 2023).
Skilled Nursing Copayment
The amount Medicare doesn’t pay for days 21-100 in skilled nursing facilities ($200 per day in 2023).
Part B Deductible
The amount Medicare doesn’t pay for outpatient services each year ($226 in 2023).
Foreign Travel Emergency
Medicare doesn’t pay for medical care in foreign countries. In some instances, it might pay 20% of these costs.
Part B Excess
Medicare doesn’t pay excess charges over the Medicare-approved amount.
*Your Medigap plan covers these shortfalls, leaving you with no out-of-pocket costs. Some plans offer better benefits than others. For instance, Plan N requires you to make a $20 copayment for doctor visits and a $50 copayment for trips to the emergency room where you are not admitted to inpatient care.
What Do Medigap Plans Not Cover?
Medigap plans do not cover dental or prescription drug coverage. They also do not cover hearing aids or eyewear.
Part B also covers preventive healthcare services at a $0 copay and a $0 deductible.
These services include the “Welcome to Medicare physical exam,” annual wellness exam, abdominal aortic aneurysm screening, bone mass measurement, colorectal cancer screening, cardiovascular disease screening, mammogram screening, diabetes screening, pap tests/pelvic exams/clinical breast exams; vaccines for flu, COVID, H1N1 flu, pneumonia, and hepatitis B.
Deductibles and copays apply to HIV screening, glaucoma tests, prostate cancer screening, Medicare nutrition therapy services, and counseling for smoking cessation.
Part D Medication Coverage
Medigap doesn’t cover your prescriptions; you’ll need to enroll in Medicare Part D for that. If you don’t use this option, there’s a 1% penalty incurred each month you aren’t enrolled in Part D if you use these services.
For instance, the Veterans Administration (VA) medication benefit is credible coverage, and you wouldn’t receive any penalty. However, retiree medication coverage employers provide may or may not be eligible.
Which Companies Sell Medigap Insurance?
While the Federal government regulates the benefits offered in Medigap plans across the industry, private insurers sell these policies. As a result, they can set premiums without following Federal guidelines.
All companies selling Medigap policies must have IDOI approval. Not all companies service all states.
Some companies may offer limited choices in the plans they offer, but all insurers must offer Plan A. Since insurers can set premiums, they may offer them at different prices in different states.
For instance, Mutual of Omaha might offer Plan N for a different price in New York and Nevada. That’s why you need a licensed, professional Medigap consultant guiding you on the best insurer to use for your Medigap policy in your state.
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Frequently Asked Questions
What are Medicare Supplement Plans, and why are they important?
Medicare Supplement Plans, also known as Medigap, are private insurance policies designed to fill the gaps in Original Medicare. They are crucial because they can help reduce out-of-pocket expenses for healthcare services.
Which are the Top 10 Medicare Supplement Plans available?
The Top 10 Medicare Supplement Plans include Plan A, Plan B, Plan C, Plan D, Plan F, Plan G, Plan K, Plan L, Plan M, and Plan N. Each plan offers different levels of coverage.
What benefits does Medicare Supplement Plan A provide?
Medicare Supplement Plan A is the most basic plan, covering Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted.
How does Medicare Supplement Plan F differ from other plans?
Medicare Supplement Plan F offers the most comprehensive coverage, covering all deductibles, coinsurance, and excess charges under Original Medicare. However, it is no longer available to new enrollees as of January 1, 2020.
What are the key benefits of Medicare Supplement Plan G?
Medicare Supplement Plan G provides almost the same coverage as Plan F, except it does not cover the Part B deductible. It has become increasingly popular due to its comprehensive coverage and cost-effectiveness.
What expenses does Medicare Supplement Plan N cover?
Medicare Supplement Plan N covers Part A coinsurance and hospital costs, Part B coinsurance (except for a copayment of up to $20 for some office visits and $50 for emergency room visits), and Part A deductible.
Are the benefits of Medicare Supplement Plans standardized across different insurance companies?
Yes, the benefits of each standardized Medicare Supplement Plan are the same, regardless of the insurance company offering them. However, premiums may vary between providers.
Can I switch from one Medicare Supplement Plan to another?
Yes, you can switch Medicare Supplement Plans at any time of the year. However, if you are outside your Medigap Open Enrollment Period, you may be subject to medical underwriting.
How can I choose the best Medicare Supplement Plan for my needs?
To find the best Medicare Supplement Plan, compare the available plans in your area, assess your healthcare needs and budget, and consider consulting with a licensed insurance agent or counselor.
Are there any additional benefits in the Medicare Supplement Plans not covered by Original Medicare?
Yes, some Medicare Supplement Plans offer additional benefits, such as coverage for foreign travel emergencies, skilled nursing facility care coinsurance, and excess charges not covered by Original Medicare.
Find the Right Medicare Plan for You
Finding a great Medicare plan for you 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.
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.