Older folks who are getting close to retirement age are frequently shocked to hear or even experience that Medicare doesn’t pay for all their medical expenses. Although it lessens the financial burden of medical expenses, the unpaid fees can mount up quickly. By law, there is a 30-day free look period when purchasing a Medigap supplement insurance plan. If, at any point during this trial period, you’re unhappy with your insurance, you can cancel your plan and get a refund. This is an excellent time to confirm that the costs and coverages of your plan meet your needs.
It’s best to first have a thorough understanding of what each component of Medicare covers in order to assist you in making an informed selection about which Medigap coverage to select.
How Does Medicare Supplement Insurance Plans Work
These policies, often known as Medigap insurance, can be obtained to cover costs that Medicare does not cover. It helps cover the gaps in original Medicare coverage. Private insurance providers offer Medicare Supplement Insurance as additional coverage to aid with copays, coinsurance, and deductibles. If you have Medicare Parts A and B, these costs may be covered by a Medigap policy; otherwise, you will be responsible for paying them.
Here’s how it generally works:
- Original Medicare Coverage
Medicare consists of two main parts: Part A (hospital insurance) and Part B (medical insurance). These cover many healthcare services, but they don’t cover everything. For example, they have deductibles, copayments, and coinsurance that beneficiaries are responsible for paying out of pocket.
- Medigap Policy Coverage
Private insurance companies sell Medicare supplement insurance policies (Medigap), which can help pay for some of the healthcare costs that original Medicare doesn’t cover.
- Standardized Plans
Medigap policies are standardized and identified by letters (e.g., Plan A, Plan B, Plan C, etc.). Each standardized plan must offer the same basic benefits, regardless of which insurance company sells it. However, costs (such as monthly premiums) can vary between insurance companies.
- Costs and Coverage
The coverage and costs of a Medigap policy depend on the plan you choose. Generally, the more comprehensive the coverage, the higher the premium. You’ll typically pay a monthly premium to the insurance company in addition to the premium you pay for Medicare Part B.
- Coverage of Specific Services
Some Medigap plans also offer coverage for services not covered by original Medicare, such as emergency medical care during foreign travel.
What Protection Does Medigap Covers
It’s essential to note that not all Medigap plans cover all of these benefits. Plans are standardized and labeled with letters (Plan A through Plan N), and each plan type offers a different combination of coverage. Additionally, Medigap plans do not cover prescription drugs, so you may need to enroll in a separate Medicare Part D prescription drug plan for medication coverage.
The coverage provided by Medigap plans can vary depending on the plan type, but generally, they cover some or all of the following:
- Part A coinsurance and hospital costs —- After you’ve paid the deductible for Medicare Part A, Medigap plans may cover the coinsurance and hospital costs for up to an additional 365 days after Medicare benefits are exhausted.
- Part B coinsurance or copayment —- Medigap plans may cover the 20% coinsurance or copayment required for Medicare Part B services after you meet the annual deductible.
- Blood —- Some Medigap plans cover the first three pints of blood you need for a medical procedure.
- Part A hospice care coinsurance or copayment —- Medigap plans may cover the coinsurance or copayment for hospice care received under Medicare Part A.
- Skilled nursing facility care coinsurance —- Medigap plans may cover the coinsurance for care received in a skilled nursing facility.
- Part A deductible —- Some Medigap plans cover the deductible for Medicare Part A, which is the amount you must pay before Medicare starts paying for hospital services.
- Part B deductible —- Certain Medigap plans cover the deductible for Medicare Part B, which is the amount you must pay before Medicare starts paying for outpatient services.
- Part B excess charges —- Medigap plans may cover excess charges if you receive medical services from a healthcare provider who doesn’t accept Medicare assignments. These charges are the difference between what Medicare approves and what the provider charges.
How Much Does Medicare Supplement Insurance Plans Costs
Only eight of the ten standardized Medigap plans—which have different degrees of cost-sharing and coverage—are accessible to newly eligible Medicare beneficiaries. The two most widely used Medicare Supplement Insurance plans that are accessible to everyone are Plan G and Plan N. The most complete option available to new Medicare enrollees is Plan G. Plan N includes lower premiums and almost as much coverage as Plan G, but there are copays for some medical visits.
The cost of a Medigap plan can vary depending on several factors, including:
- Location —- Medigap plan costs can vary by state and even by region within a state. Urban areas may have higher premiums compared to rural areas.
- Plan Type —- There are several standardized Medigap plans labeled with letters (Plan A through Plan N), each offering different levels of coverage. Generally, plans with more comprehensive coverage will have higher premiums.
- Insurance Company —- Different insurance companies may offer the same Medigap plan at different prices. It’s essential to compare costs from multiple insurers to find the most competitive rates.
- Age —- In most states, insurers can use age-based pricing for Medigap plans, meaning premiums may increase as you get older.
| Medigap Plan | Average Monthly Premiums/Costs |
| Medicare Supplement Plan A | $166 – $345 |
| Medicare Supplement Plan B | $218 – $327 |
| Medicare Supplement Plan C | $294 – $364 |
| Medicare Supplement Plan D | $290 – $339 |
| Medicare Supplement Plan F | $254 – $461 |
| Medicare Supplement High-Deductible Plan F | $64 – $156 |
| Medicare Supplement Plan G | $237 – $409 |
| Medicare Supplement High-Deductible Plan G | $64 – $144 |
| Medicare Supplement Plan K | $82 – $162 |
| Medicare Supplement Plan L | $182 – $212 |
| Medicare Supplement Plan M | $268 – $268 |
| Medicare Supplement Plan N | $191 – $312 |
Frequently Asked Questions
How do I enroll in a Medigap plan?
You must already enroll in Medicare Part A and Part B to enroll in a Medigap plan. The best time to enroll in a Medigap plan is during your six-month Medigap Open Enrollment Period, which begins the first month you’re 65 or older and enrolled in Part B. During this period, you have guaranteed-issue rights, meaning insurers can’t deny you coverage or charge you more due to pre-existing conditions. Outside of this period, acceptance into a Medigap plan may be subject to medical underwriting.
What does a Medigap plan cover?
Medigap plans help cover various out-of-pocket costs associated with Original Medicare, such as coinsurance, copayments, and deductibles. The plan type determines the coverage provided, with each plan labeled with letters (Plan A through Plan N) offering different combinations of benefits. However, Medigap plans do not cover services not covered by Medicare, such as dental, vision, or long-term care.
How much do Medigap plans cost?
The cost of a Medigap plan can vary depending on factors such as your location, age, gender, and the insurance company offering the plan. Generally, you’ll pay a monthly premium in addition to your Medicare Part B premium. Premiums can vary widely between plans, so it’s essential to compare costs and benefits before selecting a plan.
Can I switch or change my Medigap plan?
In most cases, you can switch or change your Medigap plan at any time of the year. However, if you switch plans outside of your Medigap Open Enrollment Period or a Special Enrollment Period, you may be subject to medical underwriting, which could result in higher premiums or denial of coverage. It’s essential to carefully consider your options and potential costs before making any changes to your Medigap coverage.
Conclusion
There isn’t a single health insurance plan that works for everyone. However, there’s a Medicare Supplement Insurance plan out there that suits your unique requirements. Finding a plan may be simple with AHG Brokers. Request a free quote today.