Medicare Supplement Plans
What Is a Medicare Supplement Plan (also known as Medigap Insurance)
As you may know, Medicare does not cover everything 100%. So, some people opt to purchase what’s called a Medicare Supplement Plan (sometimes called Medigap insurance). This Medigap insurance is private health insurance that helps fill in the “gaps” when Medicare doesn’t cover everything (copayments, deductibles, etc.) This saves people from high medical bills when Medicare doesn’t cover everything.
Note: This page explains Medigap Insurance in Plain English. That stated, you may still have questions, and if you do, our licensed experts can answer them, free of charge. Simply call us at 888-654-3129 ext. 3 for a free consultation.
Why You Need a Medicare Supplement Plan
Medicare is great, but it doesn’t cover everything. After you meet your Part B deductible ($185 in 2019), Medicare will pay for 80% of Medicare-approved health care expenses, leaving you responsible for the other 20%. Depending on your medical needs, this 20% can get quite high, so a Medigap policy will help pay some (or all) of this 20% (actual numbers and percentages are based on the limits of the policy you buy).
Compare Benefits on the 10 Standardized Medigap Plans
There are 10 standardized Medigap plans to choose from, and they are identified by letters, which are: Plans A, B, C, D, F, G, K, L, M, and N.
(we know this can be confusing, because Medicare itself utilizes the letters A-D as well.
Just keep in mind that, for example, “Medicare Part B” and “Medigap Plan B” are two different
things. Again, you can always call us at 888-654-3129 ext. 3 for answers.)
These 10 “lettered” plans are sold by many different insurance companies. The upside to this
naming convention is all lettered plans are the same in terms of coverage. The coverage in “Medigap A” is always the same, no matter who sells it (however, the price might be different,
depending on who sells it.)
This chart shows basic information about the different benefits that Medigap policies cover. If a percentage appears, the Medigap plan covers that percentage of the benefit, and you must pay the rest.
|Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used)||100%||100%||100%||100%||100%||100%||100%||100%||100%||100%|
|Medicare Part B coinsurance or copayment||100%||100%||100%||100%||100%||100%||50%||75%||100%||100%|
|Blood (first 3 pints)||100%||100%||100%||100%||100%||100%||50%||75%||100%||100%|
|Part A hospice care coinsurance or copayment||100%||100%||100%||100%||100%||100%||50%||75%||100%||100%|
|Skilled nursing facility care coinsurance||100%||100%||100%||100%||50%||75%||100%||100%|
|Part A deductible||100%||100%||100%||100%||100%||75%||50%||100%|
|Part B deductible||100%||100%|
|Part B excess charges||100%||100%|
|Foreign travel emergency (up to plan limits)||80%||80%||80%||80%||80%||80%|
|Out of-pocket limit in 2019|
|Plan F is also offered as a high deductible plan by some insurance companies in some states. If you choose this option, this means you must pay for Medicare covered costs (coinsurance, copayments, deductibles) up to the deductible amount of $2,300 in 2019 before your policy pays anything.|
For Plans K and L, after you meet your out of pocket yearly limit and your yearly Part B deductible ($185 in 2019), the Medigap plan pays 100% of covered services for the rest of the calendar year.
Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don't result in an inpatient admission.
When Is The Best Time to Buy a Medicare Supplement?
Medigap plans are available to people who already have Medicare or are in their Initial Enrollment Period. You can apply for a Medicare Supplement plan up to 3 months before your 65th birthday and 3 months after. In fact, buying Medigap when you turn 65 can be advantageous, as it ensures no gaps in coverage.