What is Medigap Insurance (Medicare Supplement) & the Different Plans?

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What is Medigap Insurance?

Medigap Plans are standalone insurance plans created to work in company with Traditional Medicare benefits. These supplement insurance policies provide coverage for services not covered by your Traditional Medicare.   

This includes coverage for deductibles, copayments, coinsurance and other healthcare costs that the Medicare beneficiary would be considered responsible for covering themselves.  

Medicare Supplement Plans are another name for Medigap policies and a monthly premium is paid by the insured once purchased.

While there is an additional cost on top of the deductibles required by Traditional Medicare, most seniors find they save money over time, depending on which policy they decide to go with. 

Medigap Plans Broken Down

Medigap Plans come in the form of 10 letter Plans. Depending on which type of coverage you want, or need, will depend on which letter Plan best suits your healthcare needs.  

  • Medigap Plan A: Covers Medicare Part A hospital coinsurance plus an extra 365 days after Traditional Medicare benefits have stopped. It also includes the first 3 pints of blood. Additionally, it also includes Medicare Part B coinsurance and copays, Medicare Part A coinsurance and copays and Medicare preventative care Part B’s coinsurance. 
  • Medigap Plan B: Like Plan A, it includes everything listed but also has coverage for Medicare Part A’s deductible. As of 2018, the Medicare Part A’s deductible is $1,340.00. 
  • Medigap Plan C: Like Plan A and B, Plan C carries all the same benefits and includes skilled nursing facility care coinsurance and the Medicare Part B deductible, which as of 2018 in $183.00. It also has the added benefits of foreign travel emergency benefits which cover healthcare issues while overseas. 
  • Medigap Plan D: Includes all of the same coverage that Medicare Plan C offers, however, Medicare Part B deductible is not included in the package. 
  • Medigap Plan F: Medigap Plan F is one of the best Supplement Plans available as it has the most benefits. This includes all the benefits like Medigap Plan C but has Medicare Part B excess charge coverage. Part B excess charges are allowed in some states and make it so physicians can charge more than the Medicare-approved amount. 
  • Medigap Plan F HD (High Deductible): This plan is exactly the same as Medigap Plan F, however, has a higher deductible prior to coverage pick-up. 
  • Medigap Plan G: Plan G is another popular plan, with good coverage. It has the exact same benefits as Medigap Plan F, minus the Medicare Part B deductible included in this plan coverage. 
  • Medigap Plan K: Medigap Plan K has the same plan benefits as Medigap Plan D, however, it includes some minor changes to its policy benefits. The changes affect the Medicare Part B copay and coinsurance, the first 3 pints of blood, the Medicare Part A hospice copay and coinsurance, the skilled nursing care facility coinsurance and the Medicare Part A deductible. The coverage to those specific benefits is only covered at 50%. 
  • Medigap Plan L: Medigap Plan L is the exact same as Medigap Plan K, with the changes to the decreased benefits being covered at 75% rather than 50%. 
  • Medigap Plan M: Very similar to Medigap Plan D, almost exact, except the $1,340.00 Medicare Part A deductible is only covered at 50%. 
  • Medigap Plan N: Like Medigap Plan D, Medigap Plan N has the same great benefits, however, it includes a $20.00 copay for doctor office visits and a $50.00 copay on ER visits that don’t result in a hospital admission. 

As you can see, there are plenty or options to choose from and each plan offers a variety of additional benefits. Unfortunately, there are some things Medigap benefits won’t cover. Dental and vision care, eyeglasses, hearing aids and private-duty nursing isn’t covered by any of the Medigap policies.  

Additionally, prescription drug coverage isn’t covered by either Traditional Medicare benefits or any of the Medigap Plans. However, this can be remedied by choosing a Medicare Prescription Drug Plan (PDP), which can also be purchased through the private health insurance companies. 

Medigap Eligibility

Once you’re 65 years of age and carry Medicare Part B benefits, you’re eligible for Medigap insurance. There is an Initial Enrollment Period in which you’re able to enroll 3 months prior to your 65the birthday month and the 3 months after, giving you a total of 6 months to obtain insurance.  

During this time, you have what is called your guaranteed issue rights. Regardless of any preexisting medical conditions you may have, the Medigap Plans cannot deny you coverage. Hence, the guaranteed right to the insurance policy. 

Medigap Plan Costs

Medigap Plan prices vary around the country. Regardless of which state you live in, the 10 letter Plans remain the same regarding benefits, however, the cost will vary. Each individual private insurance carrier in the state where you reside decides on what they choose to charge per policy. 

There is a variety of factors the insurance companies look when determining cost for the Medicare beneficiaries. They examine things like age, sex and location when factoring your monthly policy cost. 

Medigap vs. Medicare Advantage

Medicare Advantage Plans are also called and considered Medicare Replacement Plans. Medicare Advantage Plans are also offered by the private insurance companies in your local area. Once purchased, a Medicare Advantage Plan will completely take over coverage for your Traditional Medicare Part A and Medicare Part B benefits.

These plans are typically cheaper than the Medigap Plans, however, the Plans generally come with policy restrictions. Restrictions can include policy limitations, in-network physicians and facilities and with some plans you may have deductibles and copayments.  

While cheaper in the beginning, most seniors find that over time, the money saved from a Medigap Plan is greater than the lower monthly costs with a Medicare Advantage Plan. Additionally, you end up with better coverage and more policy benefits than what most Advantage Plans offer. You can compare them more in detail here.

More Help with Medigap Plans

There is a lot of information out there regarding supplemental insurance. When seniors factor in the added monthly cost on their already limited monthly income, they may feel like a Medigap Plan is out of their reach.

With the abundance of information and the concern about cost, seniors are often left asking themselves, “where do I turn?” 

Seniors, we can help! We can take the concern off your shoulders and make what seems like a daunting experience, very easy for you. Call our toll free 800 number or fill out our online forms.

We can help you find the best Medigap policy to fit your individual healthcare needs. We can compare rates and help get you set up with a plan today. Don’t hesitate to call. We’re dedicated to making this as easy as possible for you!