MEDICARE SUPPLEMENT PLANS

MEDICARE SUPPLEMENT PLANS

The chart below shows basic information about the different benefits Medigap policies cover.

✔= the plan covers 100% of this benefit
✘= the plan doesn’t cover this benefit
% = the plan covers that percentage of this benefit and you’re responsible for the rest
N/A = not applicable

The Medigap policy will only pay your coinsurance after you’ve paid the deductible (unless the Medigap policy also covers your deductible).

*Plans F & G offer a high deductible plan in some states. 

**Plans K & L show how much they’ll pay for approved services before you meet your out-of-pocket yearly limit and Part B deductible. After you meet them, the plan will pay 100% of your costs for approved services.

***Plan N pays 100% of the costs of Part B services, except for copayments for some office visits and some emergency room visits.

Medigap Policies

Medicare Supplement Plan, also known as Medigap policies, are insurance plans offered by private insurance companies to fill the “gaps” in Original Medicare (Part A and Part B) coverage. These gaps refer to out-of-pocket costs like deductibles, coinsurance, and copayments that beneficiaries would otherwise have to pay themselves.

Here’s a breakdown of Medicare Supplement Plan:

  • Purpose:
    • The primary purpose of a Medicare Supplement Plan (Medigap) is to help pay for certain costs not paid by Original Medicare. This can make healthcare expenses more predictable and manageable for beneficiaries.
  • Types:
    • There are 10 standardized Medigap plans available in most states, identified by letters A, B, C, D, F, G, K, L, M, and N. (Note: Plans C and F are not available to people who were newly eligible for Medicare on or after January 1, 2020.)
    • Each lettered plan offers a different set of benefits but is standardized, meaning the benefits for a Plan G, for example, are the same regardless of the insurance company or location (with some variation in Massachusetts, Minnesota, and Wisconsin).
  • Coverage:
    • Depending on the Medigap plan chosen, coverage might include:
    • Part A deductible and coinsurance
    • Part B deductible and coinsurance or copayments
    • Blood (first 3 pints each year)
    • Hospice care coinsurance or copayment
    • Skilled nursing facility care coinsurance
    • Foreign travel emergency coverage (up to plan limits)
  • Some plans also offer an out-of-pocket maximum, which can provide additional financial protection.
  • Cost:
    • Beneficiaries pay a monthly premium for their Medigap policy in addition to the monthly Part B premium.
    • Premiums can vary widely based on several factors, including age, location, and the insurance company.
  • Enrollment:
    • The best time to buy a Medigap policy is during the 6-month Medigap open enrollment period, which starts the month a person turns 65 and is enrolled in Medicare Part B. During this period, an insurance company can’t use medical underwriting, meaning they can’t charge more or deny coverage based on health status.
    • If trying to buy or switch Medicare Supplement Plans(Medigap) after this period, you may be subject to medical underwriting unless you qualify for a guaranteed issue right.
  • Medicare Advantage vs. Medigap:
    • It’s essential to understand that Medigap policies supplement Original Medicare. If a beneficiary is in a Medicare Advantage Plan (Part C), they can’t use a Medigap policy to pay for expenses. In fact, it’s illegal for someone to sell you a Medigap policy if you’re in a Medicare Advantage Plan, unless you’re switching back to Original Medicare.
  • Guaranteed Renewability:
    • Medigap policies are guaranteed renewable, meaning as long as you pay the premium, the insurance company can’t terminate the policy even if health problems arise.

When considering a Medigap policy, it’s essential to compare the various plans and understand what each plan covers. Beneficiaries should also review their needs annually, as healthcare needs and available policies may change over time.

source
www.medicare.gov

What’s Great About The Plans

The following are features of Medicare Supplement Plans

30 Days Free Look

Return any policy for any reason within 30 days after receipt for a full refund of all premiums.

Go Direct to Your Doctor

You can go directly to the physicians and specialists you choose, that accept Medicare patients, without pre-certifications and pre-approvals.

12-Month Rate Guarantee

No rate increase for the first 12 months, as long as the premiums are paid on time.

Benefits Stay the Same

You always know what your benefits are with this standardized plan…no surprises or re-evaluations year-after-year.

Guaranteed Renewable

No worries of reduced benefits or canceled coverage for the life of the policy, as long as the premiums are paid.

Portable Coverage

You are not restricted to use a network of health care providers. If you move, your coverage goes with you.

Take the Next Step to Peace of Mind

Our team of licensed agents are here to weigh your options and find the perfect plan for your needs. Each of our local reps are dedicated to providing the highest level of service ensuring your satisfaction.