Original Medicare (Parts A and B) does not pay for everything, which can leave beneficiaries on the hook for out-of-pocket costs. But Medicare Supplement plans can help. Also called Medigap, Medicare Supplement plans are sold through private insurance companies and help fill the “gaps” in Original Medicare coverage. Approximately 11 million Medicare beneficiaries chose a Medigap plan to help with their healthcare expenses, according to a recent KFF study.1
When searching for a Medigap plan, there are several options from which to choose. To select the best Medicare Supplement plan for your needs, learn about your options.
What Are My Options for the Best Medicare Supplement Plan?
It’s important to know that you can only use a Medigap plan if you have Original Medicare (Parts A and B). As of 20201 there are eight different Medicare Supplement plans sold to new beneficiaries: A, B, D, G, K, L, M, and N. Each Medicare Supplement plan must include the same standardized benefits regardless of carrier and location.* However, different types of Medicare Supplement plans offer different levels of coverage. (For example, Plan N offers different coverage levels than Plan G). Medigap policies are guaranteed renewable, which means—as long as you pay the premium—they can’t be canceled for health reasons.
How Much Does Medicare Supplement Insurance Cost?
The cost of a Medicare Supplement plan varies depending on the insurance company. The average monthly premium price can range from $150 to $200.1 To choose the best Medicare Supplement plan for your needs, you must be aware of any out-of-pocket costs that come with each plan. These costs can include monthly premiums and yearly deductibles.
What Do Medicare Supplement Plans Cover?
Each Medigap plan covers basic benefits, such as:
- Coinsurance charges through Medicare Plan A (up to 365 days after Original Medicare benefits are spent)
- Hospice care copayments and coinsurance through Medicare Plan A
- Copayments and coinsurance through Medicare Plan B
- The first three pints of blood needed due to a medical procedure
Most Medicare Supplement plans do not cover:
- Long-term care
- Hearing aids
- Private-duty nursing
Also, it’s important to note that Medigap plans won’t start to cover your coinsurance until your deductible is met, unless deductibles are also covered. Plans K and L have annual out-of-pocket spending limits, after which you’re covered 100%. While there is no overall best Medicare Supplement plan, you can make the right choice for your priorities and budget. If you need help determining what your best Medicare Supplement plan option is, ask yourself the following questions:
Do I travel a lot?
If you do, you’ll probably want to select a plan that offers foreign travel emergency coverage for when you’re traveling abroad. Plans C, D, E, F, G, H, I, J, M, and N pay 80% of qualifying emergency care in foreign countries. Foreign travel coverage begins when you meet your annual $250 deductible. For the first 60 days you travel, you’re covered for qualifying care that Medicare doesn’t otherwise pay for, with a lifetime limit of $50,000.
Do I want help with Part B costs?
Plan G will help pay your Part B excess charge (the payment between the Medicare-approved amount and the maximum a doctor can charge). And while all Medicare Supplement plans offer some coverage for Part B coinsurance and copayments, Plan K only covers 50%, and Plan L covers 75%. Plan N covers these costs 100%, with the exception of a $20 office visit copay or $50 emergency room copay in certain situations.
Do I want a plan with an out-of-pocket limit?
Consider Medicare Supplement Plans K or L. For 2022, Plan K covers you 100% after you’ve spent $6,620. Plan L kicks in with 100% coverage after spending $3,310.2 However, keep in mind that these two plans offer the least amount of coverage before you reach the out-of-pocket limit.
Do I want the maximum possible coverage?
If so, Plan G may be the right Medicare Supplement Plan for you. Of all the Medicare Supplement plans, it gives the most comprehensive coverage to new Medicare beneficiaries. People with Plan G are 100% covered for all Medicare Supplement benefits, except foreign emergency care. Like other Medigap plans, Plan G covers 80% of qualifying foreign emergency care expenses.
2020 Medigap Changes
As of January 1, 2020, new Medicare enrollees can no longer purchase plans that cover the Medicare Part B deductible. This change affected Plans C and F, making them no longer available to new enrollees. However, beneficiaries who were already enrolled in Plan C or F can maintain their coverage.
When Should I Buy Medicare Supplement Insurance?
It’s best to buy Medicare Supplement insurance within the first six months after you turn 65 and enroll in Medicare. During that time, you can buy any Medigap policy sold in your state, even if you have health problems. After this six-month period, you may not be able to enroll in a Medicare Supplement plan, or you may have to pay more due to pre-existing conditions or current health problems.
Do I Have to Purchase Medicare Supplement Insurance?
No, you are not required to buy a Medicare Supplement plan with Original Medicare (Parts A and B). However, without a Medicare Supplement plan, you could be responsible for the full out-of-pocket costs of deductibles, copays, and other healthcare expenses.
Do I Need Separate Drug Coverage With Medicare Supplement Insurance?
Yes, you’ll need to purchase a Part D drug coverage plan from a private insurance company if you have a Medicare Supplement plan. Neither Original Medicare nor your Medicare Supplement plan will cover your prescriptions. It’s also important to enroll in a Part D plan when you initially qualify for Medicare to avoid a penalty that is enforced for the duration of your drug coverage.
I Can Help Find Your Medicare Supplement Plan
If you need help finding a Medicare Supplement plan, call me to get started. I can help you determine whether a Medicare Supplement plan is the right choice for your needs, at no cost to you.