Medicare Supplement Insurance Plans: What You Need to Know

For many Americans, Medicare provides essential health care coverage once they turn 65. However, even with Medicare, you may still face out-of-pocket expenses for certain medical services. That’s where Medicare supplement insurance plans come in.

What Are Medicare Supplement Insurance Plans?

Also known as Medigap plans, Medicare supplement insurance plans are designed to help cover some of the costs that Medicare doesn’t pay for, such as deductibles, copayments, and coinsurance. These plans are offered by private insurance companies and can help you save money on your health care costs.

There are 10 standardized Medigap plans available in most states, labeled A through N. (Note that Massachusetts, Minnesota, and Wisconsin have their own standardized plans.) Each plan offers different types and levels of coverage, so it’s important to understand what each one includes before you choose a plan.

Table 1: Summary of Medicare Supplement Insurance Plans

What Do Medicare Supplement Insurance Plans Cover?

While every Medigap plan must cover the basic benefits of Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up, other coverage can vary depending on the plan you choose. Here’s a closer look at what each plan typically covers:

Plan A

Plan A is the most basic Medigap plan and only covers the basic benefits listed above.

Plan B

In addition to the basic benefits, Plan B also covers Medicare Part A deductible and skilled nursing facility coinsurance.

Plan C

Plan C covers all of the benefits of Plan B, as well as the Medicare Part B deductible and foreign travel emergency care.

Plan D

Plan D covers all of the benefits of Plan A, as well as skilled nursing facility coinsurance. It does not cover the Medicare Part A or Part B deductible.

Plan F

Plan F is one of the most comprehensive Medigap plans and covers all of the benefits of Plan C, as well as the Medicare Part B excess charges. It also covers at-home recovery and preventive care coinsurance.

Plan G

Plan G covers all of the benefits of Plan F, except for the Medicare Part B deductible.

Plan K

Plan K covers all of the basic benefits of Medigap, as well as skilled nursing facility coinsurance and at-home recovery. However, it only covers 50% of the Part A deductible and none of the Part B deductible or excess charges.

Plan L

Plan L is similar to Plan K, but covers 75% of the Part A deductible and also includes foreign travel emergency care.

Plan M

Plan M covers all of the basic benefits of Medigap, as well as skilled nursing facility coinsurance and the Part A deductible. It also covers 80% of the foreign travel emergency costs.

Plan N

Plan N covers all of the basic benefits of Medigap, as well as the Medicare Part A deductible and skilled nursing facility coinsurance. It also covers 100% of the Part B coinsurance, except for up to a $20 copayment for office visits and up to a $50 copayment for emergency room visits.

How Do I Choose a Medicare Supplement Insurance Plan?

Choosing the right Medigap plan for your needs can be overwhelming, especially with so many options to choose from. Here are some factors to consider:

Your Health Care Needs

Think about the types of medical services you’re likely to need in the coming year and choose a plan that covers those services. If you’re generally healthy and don’t anticipate needing many medical services, you may be able to choose a less comprehensive plan.

Your Budget

Consider how much you can afford to pay in monthly premiums and out-of-pocket costs. Keep in mind that more comprehensive plans will generally have higher premiums.

The Insurance Company

Choose an insurance company that is financially stable and has a good reputation for customer service. You may also want to consider whether the company offers any extra benefits, such as discounts on gym memberships or wellness programs.

Your Location

Some Medigap plans may not be available in your area, or may be offered at different prices depending on where you live. Make sure to check which plans are available in your state and compare prices before making a decision.

Frequently Asked Questions About Medicare Supplement Insurance Plans

What’s the difference between Medicare Advantage and Medicare supplement insurance plans?

While both types of plans are designed to help cover some of the costs that Medicare doesn’t pay for, they work in different ways. Medicare Advantage plans are offered by private insurance companies and often include additional benefits, such as prescription drug coverage or dental care. In contrast, Medigap plans are designed to work alongside Original Medicare, and you may need to pay a separate premium for them.

When is the best time to enroll in a Medigap plan?

The best time to enroll in a Medigap plan is during your initial enrollment period, which starts when you’re first eligible for Medicare and lasts for six months. During this time, you can enroll in any Medigap plan offered in your area without being turned down or charged more due to pre-existing conditions. If you miss this window, you may still be able to enroll in a Medigap plan, but you may need to pay higher premiums or be subject to medical underwriting.

Can I switch Medigap plans?

Yes, you can switch Medigap plans at any time. However, if you want to switch to a new plan, you may need to go through medical underwriting, which could mean higher premiums or being denied coverage altogether if you have pre-existing conditions.

Can I have a Medigap plan and a Medicare Advantage plan at the same time?

No, you cannot have both types of plans at the same time. If you have a Medigap plan, you cannot enroll in a Medicare Advantage plan. However, if you have a Medicare Advantage plan and decide to switch to Original Medicare, you may be able to enroll in a Medigap plan at that time.

What happens to my Medigap plan if I move to a new state?

If you move to a new state, you may need to switch to a new Medigap plan. Some plans may not be available in your new location, or may be priced differently. Make sure to check with your insurance company before you move to ensure that your coverage will continue.

In Conclusion

Medicare supplement insurance plans can be a valuable way to help cover some of the costs of health care that aren’t covered by Medicare. With so many options available, it’s important to carefully consider your needs and budget when choosing a plan. By doing your research and comparing plans, you can find the Medigap plan that’s right for you.