Medicare Supplements
Medicare Supplement plans, often referred to as Medigap, help cover out-of-pocket expenses not paid by Original Medicare. This includes costs such as deductibles, coinsurance, copayments, and hospital costs that Medicare does not cover. These plans are provided by private insurance companies that are approved by Medicare.
Additional Medicare Supplement Benefits
Medicare Supplement (Medigap) plans are designed to cover the costs not paid by Original Medicare, and they may also offer additional benefits, including:
Coverage for Healthcare Abroad
Some plans provide coverage for medical care received while traveling outside the United States.
No Referrals Needed
You do not need referrals to see specialists, allowing you greater flexibility in accessing specialized care.
Zero Out-of-Pocket Costs
Depending on the plan, some Medigap policies may cover all out-of-pocket expenses, leaving you with no additional costs.
Freedom to Choose Providers
You can select your primary care doctor and visit any hospital or provider that accepts Medicare Assignment, giving you a wide range of choices.
Protection Against Discrimination
Once enrolled, you cannot be removed from your Medigap plan due to health reasons, providing stability in your coverage.
Medicare Supplement Plans
If you choose not to enroll in Medicare Part D prescription drug coverage when you first become eligible, you may incur a late enrollment penalty. This penalty is added to your monthly premium and generally applies for as long as you have Part D coverage.
The 10 Medicare Supplement (Medigap) plans are: A, B, C, D, F, G, K, L, M, and N. Additionally, high-deductible versions of Plans F and G are available in some regions. The standard versions of Plans F and G are popular for their extensive coverage.
Regardless of which private insurance company you choose, all Medigap plans must adhere to Medicare’s standardized benefits. This means that each plan offers the same coverage regardless of the carrier; the only difference will be the monthly premium.
Medicare "Must-Know" Information
How do Medicare Supplements Work
To enroll in a Medigap plan, you must first be enrolled in both Medicare Parts A and B (Original Medicare). This enrollment period is known as the Medicare Supplement Open Enrollment Period, which lasts for six months starting from when you first have Part B coverage. During this period, you can choose a Medigap plan without facing denial due to health conditions or being charged higher premiums.
Here's how it works: When you receive medical services, Medicare will first process your bill and cover approximately 80% of the costs. The remaining balance will be sent to your Medigap plan. Your Medigap plan will then cover most or all of these remaining expenses. Any costs not covered by your Medigap plan will be your responsibility.
Do you need a Medicare Supplements?
Whether you choose to get Medicare Supplement insurance depends on your individual health needs. Like Medicare Part D, Medigap insurance is optional. However, without it, you’ll be responsible for the remaining 20% of outpatient costs not covered by Medicare. Many Medicare beneficiaries opt for a Medigap policy to help manage their out-of-pocket expenses and gain peace of mind with more comprehensive coverage.
Medicare Supplement Plans
Here’s an overview of what each Medicare Supplement (Medigap) plan covers. Note that Plans C and F are no longer available for those who became Medicare-eligible after January 1, 2020.
Medigap Plan A
-Covers 100% of:
-First three pints of blood
-Part A hospice care coinsurance
-Part A coinsurance and hospital costs
-Part B coinsurance and hospital costs
Medigap Plan B
-Covers 100% of:
-Part A deductible
-First three pints of blood
-Part A hospice care coinsurance
-Part A coinsurance and hospital costs
-Part B coinsurance and hospital costs
Medigap Plan C
-Covers 100% of:
-Part A deductible
-Part B deductible
-First three pints of blood
-Skilled nursing facility care
-Part A hospice care coinsurance
-Part A coinsurance and hospital costs
-Part B coinsurance and hospital costs
-Also covers 80% of foreign travel emergency care
Medigap Plan D
-Covers 100% of:
-Part A deductible
-First three pints of blood
-Skilled nursing facility care
-Part A hospice care coinsurance
-Part A coinsurance and hospital costs
-Part B coinsurance and hospital costs
-Also covers 80% of foreign travel emergency care
Medigap Plan F
-Covers 100% of:
-Part A deductible
-Part B deductible
-Part B excess charges
-First three pints of blood
-Skilled nursing facility care
-Part A hospice care coinsurance
-Part A coinsurance and hospital costs
-Part B coinsurance and hospital costs
Medigap Plan G
-Covers 100% of:
-Part A deductible
-First three pints of blood
-Skilled nursing facility care
-Part A hospice care coinsurance
-Part A coinsurance and hospital costs
-Part B coinsurance and hospital costs
-Also covers 80% of foreign travel emergency care
Medigap Plan K
-Covers 100% of:
-Part A coinsurance and hospital costs
-First three pints of blood
-Part A hospice care coinsurance
-Also covers 50% of:
-Part B coinsurance and hospital costs
-Skilled nursing facility care
-Part A deductible
-Coverage of foreign travel emergency care is not included
Medigap Plan L
-Covers 100% of:
-Part A coinsurance and hospital costs
-First three pints of blood
-Part A hospice care coinsurance
-Also covers 75% of:
-Part B coinsurance and hospital costs
-Skilled nursing facility care
-Part A deductible
-Coverage of foreign travel emergency care is not included
Medigap Plan M
-Covers 100% of:
-Part A coinsurance and hospital costs
-First three pints of blood
-Part A hospice care coinsurance
-Part B coinsurance and hospital costs
-Also covers 50% of:
-Part A deductible
-Coverage of foreign travel emergency care is not included
Medigap Plan N
-Covers 100% of:
-Part A coinsurance and hospital costs
-First three pints of blood
-Part A hospice care coinsurance
-Part B coinsurance and hospital costs
-Also covers:
-Copayments for office visits and emergency room visits (except for a small copayment)
-Coverage of foreign travel emergency care is not included
The most popular plans, such as Plans F, G, and N, are favored for their comprehensive coverage. Remember that each Medigap plan is standardized, meaning that benefits remain consistent regardless of the insurance company, though premiums may vary.
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