by Russell Noga | Updated January 10th, 2024
Whether you’re about to retire or you have been diagnosed with a chronic medical condition or a disability, making sure that you have health insurance is essential. Without insurance, the cost of medical care can be exorbitant and can even lead you to bankruptcy. Medicare provides the health insurance that millions of Americans require.
The government-sponsored health insurance program features several parts, and Part A and Part B combined are known as Original Medicare. If you recently enrolled in Original Medicare or you plan on enrolling in the near future, there’s no doubt that you’ll be grateful for the coverage it provides.
However, while Part A and Part B will cover a lot of your medical expenses, it won’t cover everything, and you’re responsible for paying the expenses and services it doesn’t cover. Those out-of-pocket expenses can become exorbitant and for many, can lead to financial struggle. Fortunately, Medicare Supplement Insurance (Medigap) can help to cover those expenses.
There are several Medicare Supplement Insurance plans. To ensure you choose the option that will best meet your needs, carefully comparing the different policies is vital. In this guide, we highlight the importance of comparing Medicare Supplement plans, the different types of plans that are available, and how to compare your options.
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Why You Should Compare Medigap Plans
Medicare Supplement Insurance – also known as Medigap – is supplementary insurance that is designed to fill in the gaps in Original Medicare coverage. In other words, it covers the costs that Part A (inpatient care) and Part B (outpatient care) don’t cover.
There are a total of 10 plans, which are sold by private health insurance companies, and the plans offer standardized benefits that the federal government requires.
The policies, which are named for letters, cover different out-of-pocket expenses.
Not only do benefits vary from policy to policy, but so do the rates. Additionally, insurance companies set their own rates, and while the policies insurers offer must provide standardized benefits, companies can offer their policyholders different benefits.
Since the benefits and rates vary from plan to plan and provider to provider, comparing your options is essential, as doing so will ensure that you choose a Medigap policy and an insurer that meets your specific needs.
Types of Medicare Supplement Plans
As mentioned, there are a total of 10 Medigap policies. These policies are named for letters, including Plan A, B, C, D, F, G, K, L, M, and N, and each plan offers different benefits. The following is a brief overview of the benefits that each policy provides:
- Plan A. The most basic of all Medicare Supplement Insurance policies, Plan A only covers the expenses that the federal government requires, and nothing more.
- Plan B. This plan is a step up from Plan A. It offers the same benefits as Plan A, and it covers the cost of the Part A deductible.
- Plan C. This is considered one of the more inclusive policies, as it includes everything Plan A and Plan B offer, as well as the cost of the Part B deductible, skilled nursing facility coinsurance, and emergency medical care while traveling abroad.
- Plan D. Plan D also covers everything Plan A, B, and C cover, but it does not cover the Part B deductible.
- Plan F. Plan F is the most comprehensive of all Medigap policies, as it covers everything that Medicare Part A and Part B don’t cover.
- Plan G. Plan G covers all the expenses that Plan F covers, except the Part B deductible.
- Plan K. Plan K will cover Part A coinsurance and hospital expenses, and 50 percent of Part B coinsurance, and coinsurance or copayments for hospice care.
- Plan L. This plan offers the same benefits as Plan K, but it covers 75 percent of the Part B coinsurance and hospice care copayments or coinsurance.
- Plan M. This plan covers everything Plan D includes, except the Part B deductible. Additionally, it covers 50 percent of the Part A deductible.
- Plan N. Plan N includes all the benefits that Plan D offers, except the Part B deductible and some copays and coinsurance. For example, copays for doctor visits can cost up to $20 and copays for ER visits can cost up to $50 (the fee is waived if you’re admitted to the hospital). In exchange, however, the monthly premiums for Plan N are lower.
How to Compare Medigap Plans
When you’re comparing Medicare Supplement Insurance plans, there are several factors to consider. The following tips can help you choose the right policy for your unique needs.
- Find out what plans are available in your location. While Medigap plans are standardized by the government, not all plans are available in all locations. When you’re comparing policies, make sure you find out which options are available in your state.
- Compare coverage options. Once you’ve identified which plans are available in your state, compare the benefits that each plan offers. As highlighted above, different plans cover different Part A and Part B expenses and services, so finding out exactly what benefits each plan offers is essential so that you can determine which option will best meet your needs.
- Consider your budget. Medigap plans also vary in terms of price. Insurance companies set their own rates, and there are several factors that can influence the rates that each insurer charges; age, health, location, gender, tobacco use, etc. Also, policies that offer more coverage tend to cost more than those that provide fewer benefits.
- Check out the provider network. Make sure you look into the provider network for different Medigap plans. If there’s a specific healthcare provider or hospital that you like to use, make sure that they’re in the network of the policy you’re considering. If they aren’t, you’ll end up having to pay out-of-network fees, which can really add up.
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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.