What's Medicare Supplemental Insurance (Medigap)?
A Medicare Supplement Insurance (Medigap) policy helps pay some of the health care costs that Original Medicare doesn't cover, like:
- Copayments
- Coinsurance
- Deductibles
Medigap policies are sold by private insurance companies that have been approved by Medicare.
Federal law requires every company that offers Medicare Supplement plans must have the exact same coverage, the only difference is the monthly payment and the name on your insurance cards. Empowered with this basic knowledge it makes things so much simpler for you to compare the different plans because you're literally only comparing the pricing, not the coverage or network. Every Medigap policy is accepted the same everywhere that Medicare is accepted.
In no particular order, the following Insurance companies are often among the most popular choices for people buying a Medigap policy due to brand recognition or previous experience.
Some Medigap policies also cover services that Original Medicare doesn't cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, here's what happens:
Medicare will pay its share of the Medicare-approved amount for covered health care costs.
Then, your Medigap policy pays its share.
7 things to know about Medigap policies
- You must have Medicare Part A and Part B.
- A Medigap policy is completely different from a Medicare Advantage Plan.
- You pay the private insurance company a monthly premium for your Medigap policy. You pay this monthly premium in addition to the monthly Part B premium that you pay to Medicare.
- A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you'll each have to buy separate policies.
- You can only buy a Medigap policy from a licensed insurance agency or broker that's licensed in your state to sell one.
- Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can't cancel your Medigap policy as long as you pay the premium.
- Medigap policies aren't allowed to include prescription drug coverage. You must purchase a separate Medicare Prescription Drug Plan (Part D) in order to avoid life-time penalties to your Part D premiums.
Medigap policies don't cover everything
Medigap policies generally don't cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.
Insurance plans that aren't Medigap
Some types of insurance aren't Medigap plans, they include:
- Medicare Advantage Plans (like an HMO, PPO, or Private Fee-for-Service Plan)
- Medicare Part D Prescription Drug Plans
- Medicaid
- Employer or union plans, including the Federal Employees Health Benefits Program (FEHBP)
- TRICARE
- Veterans' benefits
- Long-term care insurance policies
- Indian Health Service, Tribal, and Urban Indian Health plans
What are the different Medicare Supplemental Plans?
Each Medicare supplement plan in the chart below has a letter, A – N. Each plan provides different comprehensive benefits. However, as we mentioned before, each lettered plan must have the same standardized coverage regardless of which insurance company you choose. That means that a Plan G from Blue Cross Blue Shield has the EXACT same benefits as Plan G from United Healthcare.
The Medicare supplement chart below shows the 10 standardized Medicare supplement plans. These plans can be offered by insurance companies in most states. Wisconsin, Minnesota and Massachusetts have different options though.
Since we specialize in Medicare supplemental insurance for seniors with Medicare we can help you determine which one best suits you and review the pricing for every insurance carrier that offers the plan.
* Medigap Plan F enrollment will no longer be available to newly eligible Medicare Beneficiaries effective January 1st, 2020.
* Plan F & Plan G are also offered as a high-deductible plan by some insurance companies in some states. If you choose the high-deductible option, it means you must pay for Medicare-covered costs (coinsurance, copayments, deductibles) up to the deductible amount of $2300 in 2019 before your policy will pay anything.
**For Medigap Plans K and L, after you meet your annual out-of-pocket limit and your annual Part B deductible ($185 in 2019), the Medigap plan pays 100% of covered services for the rest of that calendar year.
***Plan N pays 100% of the Part B coinsurance, except for a co-pay of up to $20 for some office visits and up to a $50 co-pay for emergency room visits that don’t result in an inpatient admission.
You can find this information as well as other great info in Medicare’s annual "Medicare & You" handbook as well, which you can find here.
How do I pick a Medicare Supplement plan?
In 2020, most people are enrolling into Medicare supplement plans G or N. That’s because Plan F is no longer available to newly eligible beneficiaries and these two plans offer the most coverage.
However, you have choices to determine what's best for your situation. Some people want a plan that covers EVERYTHING and leaves them with zero worries about medical bills. Other people prefer a Medicare supplement plan in which they cover only some of their deductibles and co-pays in order to achieve lower premiums.
It's not a one-size-fits-all scenario. What works best for your neighbor may not be the bet for you! Usually people make a decision based on their budget and their health... If you only go to the doctor for regular check-ups, you may want to trade a lower premium for co-pays. On the other side of that same coin, if you've had a history of health concerns, a more comprehensive plan may make more sense so that you're only providing your insurance card at the time of service instead of digging into your wallet or purse to pay a pesky co-pay.
As a licensed insurance broker, we will provide quotes for several plans and see what makes the most sense to you in terms of coverage and pricing.
What is the average cost of Medigap supplemental insurance?
Pricing for Medigap supplement policies varies by state and plan. Medicare supplement companies also base their rates on gender, zip code, tobacco usage, and age. Some individuals may also benefit from household discounts.
For quotes in your own zip code, give us a call at 800-860-0459
In some states like Florida, the premiums are higher because the cost of healthcare services in that area is higher. For example, we might be able to find a Plan G for someone turning-65 non-tobacco user for around $100/month in many States while the same policy would cost more than twice that in Florida.
When do I enroll into Medigap?
If you've started to receive all the brochures in the mail and phone calls, then you're probably able to get started now. Keep in mind that during your initial open enrollment, the Insurance companies are not allowed to ask you any medical questions and they can't refuse you a policy or charge you any additional amount due to health conditions, medications or pre-existing illnesses. Everyone has all of the same access to these plans.
After your open enrollment window passes, however, insurance companies you apply to may require you to pass medical underwriting and that may mean that you're declined based on your health. That is why the handbook states that open enrollment is the best time to enroll.
You may enroll in these policies as early as six (6) months before your Medicare effective date (The first day of the month in which your turn 65) and up to three months after the month in which you turn 65.
How do I find the Right Medicare Supplemental Insurance?
If you purchase a policy directly from an insurance company, you forfeit many benefits. Buying through Simple Senior Care costs you the exact same, but we also provide these valuable FREE services to all of our policyholders.
- Full-time Customer Service Team to answer your Medicare questions
- Annual Medicare changes Webinars & Documentation (Every Fall!)
- Real-time quotes for 30+ companies
- Compare the historical rate increases for each carrier
- Gain free financial ratings and other insight into each company
- Annual Broker assisted rate comparison to keep your premiums as low as possible
- Annual Medicare Part D Prescription Drug Plan assistance for renewal (Every Fall!)
Don’t hesitate to contact us for more information and quotes for all of the companies that offer plans in your area. Call (800) 860-0459 or click below for help.