Medicare Supplement Plans
Medicare Supplement Plans: Which one is right for you?
There are many Medicare Supplement plans available from multiple companies.
Medicare Supplement plans (also called Medigap plans) are types of health insurance you may purchase to fill gaps in your original Medicare Part A and B.
Medigap plans pay for all or part of your copayments, deductibles, and other charges Medicare may not cover.
Insurance companies can only sell you one of 12 different “standardized” Medigap policies identified by the letters A, B, C, D, F, G, K, L, M, N, and a high deductible version of F and G.
Each policy with the same letter code must offer the same benefits, no matter which insurance company provides the policy. Therefore, cost is usually the only difference between Medigap policies sold by different insurance companies.
That is why it is so important to get the best price on your Medigap coverage.
Example:
Mary is a 68-year-old non-smoker. She is interested in a Plan F Medicare Supplement. We collected quotes from several different insurance providers. The range in the monthly premiums charged by these companies is alarming:
Company 1: $187 Company 2: $272 Company 3: $149
Three companies are offering the SAME insurance policy for very different prices… Which would you choose?
Enrolling in a Medicare Supplement Plan
The Medicare Supplement Open Enrollment Period begins on the first day of the month in which you are both 65 years of age (or older) and you are enrolled in Medicare Part B. This period lasts 6 months.
This 6 month period is the best time to purchase your Medicare Supplement because an insurance company cannot turn you down… apply any conditions… or charge a higher premium due to a health problem.
Insurance companies can apply a waiting period to your Medigap Policy for pre-existing conditions, but that can be eliminated or shortened if you have had prior credible coverage before enrolling in Medicare Part B, either through an employer or with an individual plan you purchased for yourself.
A Closer Look at the Medicare Supplement Plans
If a checkmark appears in the column, this means that the Medigap policy covers that benefit up to 100% of the Medicare-approved amount. If a column lists a percentage, this means the Medigap policy covers that benefit at that percentage rate of the Medicare-approved amount. If no percentage appears or if the column is blank, this means the Medigap policy does not cover that benefit. Note: The coverage of Part A and B coinsurance only begins after the deductible has been satisfied (unless you choose a plan that also covers the deductibles).
All Medigap Plans Offer These 4 Basic Benefits
- Part A Coinsurance for inpatient hospital days 61-90 ($408 per day) and days 91-150 ($816 per day), accumulated over your lifetime.
- Payment in full for 365 additional hospital days, accumulated over your lifetime.
- 20% Part B coinsurance for physician visits and other Medicare Part B services.
- Blood services – first 3 pints.
Depending on which one you choose, your Medigap Plan may also cover these costs: (amounts listed are for 2018)
- Medicare Part A Hospital Deductible of $1,632.00
- Skilled Nursing Facility (SNF) Coinsurance of $204.00 daily for days 21-100 in a Skilled Nursing Facility. You are responsible for all charges after day 100.
- Medicare Part B Yearly Deductible of $240.00
- Medicare Part B Excess Charges. These occur when your doctor charges more for a service than Medicare’s approved rate. Doctors can charge up to 15% more as an “excess charge”. Unless your Medigap plan covers these, you are responsible for paying these fees.
- Foreign Travel Emergency Care during the first 60 days of your travel, your plan may cover at 80% after you pay a $250 deductible. The lifetime maximum foreign travel benefit is $50,000.
- Of all the Medigap plans, only Plan F includes all of the available benefits.
Making the Comparison
This chart shows a comparison across plans along with why Plan N might be the preferred choice moving forward.
Serving as a Resource as You Navigate Medicare
If you’re wondering how to best manage your risk with Medicare, view our short video where we share insights and explain how to think about your risks on Medicare.
