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Medicare Supplement Plans (Medigap Plans)

Medicare Supplements are often confused with Medicare Advantage, but they are vastly different. While Medicare Advantage is a way to add coverage options (dental, vision, prescription drugs, etc.) to your plan, Medicare Supplement is a way to add financial benefits (help paying for your copayments, coinsurance, and deductibles). You may hear Medicare Supplements referred to as “Medigap Insurance” because they can help close the gap between what you need to pay and what you have coverage for.

Included in Medicare Supplement Plans (Medigap plans):

What is Covered Under a Medicare Supplement Plan?

Medigap plans, much like Medicare Advantage plans, can vary. Unlike Medicare Advantage plans, Medigap plans are organized by letter. Carriers label their plans by A, B, C, D, F, G, K, L, M, and N. Each letter represents different coverage levels and costs. These letters will apply to every state except Massachusetts, Minnesota, and Wisconsin. Wisconsin only has one Medigap plan option, and Massachusetts and Minnesota only have two. An agent in your area can help you figure out what your options are.

Medicare Supplement Plan F is one of the most popular plans because it has the most benefits. Combining this Medigap plan with Medicare Parts A & B provides you with the most comprehensive coverage. Why people consider Plan F one of the best Medicare Supplement plans is partly due to it offering coverage for Part B Deductibles, Part B Excess Charges, and coverage for foreign travel emergencies. While other plans do offer these benefits, no other plan offers all three.

As of January 1, 2020 Medicare Supplement Plan F will no longer be available. Any Medigap plans that offer Part B deductible coverage are being discontinued so that will mean Plan C will go away as well. Luckily the Part B deductible is relatively low right now at less than $200 for the year so the loss of this benefit is not drastic. If you already have a Medicare Supplement Plan F prior to the cut off date you will not lose your plan, but the premiums may increase.

The second most popular plan is Medicare Supplement Plan G. This Medigap insurance plan is similar to Plan F in all but one way. Plan G does not offer coverage for the Part B deductible. You will be responsible for the full payment of the deductible with this plan but you will probably see some savings compared to Plan F on your monthly premiums.

After January 1, 2020 when Plan F is discontinued a Medicare Supplement Plan G will become the next most popular plan. Plan G offers the same benefits as Plan F except for coverage of the Part B deductible.

Some Medigap policies provide coverage for prescription drugs as well. However, if your Medigap policy covers prescription drugs, you cannot also have a separate prescription drug plan.

Medicare Supplement Plan Benefits | Medicare Supplement Plan Finder | Medicare Plan Finder

Pros and Cons of Medicare Supplement Insurance

Pros

  • Medicare Supplements help cover copayments, coinsurance, and deductibles
  • Medigap plans offer the same exact benefits no matter where you live (exceptions for MA, MN, and WI listed above). The costs associated with each plan can differ depending on which state and county you live in.
  • You have the freedom to see any doctor or specialist that accepts Medicare
  • The highly popular Medicare Supplement Plan F offers benefits above and beyond most Medigap plans and covers Part B deductibles, Part B excess charges, and foreign travel emergency coverage.

Cons

  • Most Medigap insurance does not offer prescription drug, dental, vision, or hearing coverage.
  • Your premium will be higher for Medigap than it would be for Original Medicare only.
  • Medicare Supplement premiums will most likely increase each year

Does Medicare Supplemental Insurance Cover Pre-existing Conditions?

The short answer here is yes, but when you apply is crucial to getting the most out of your plan. If you apply for a plan during your Medigap initial enrollment period (which begins three months before you turn 65 and ends three months after) and you have Medicare Part B, you will have what is referred to as “guaranteed issue rights.” These rights ensure you the below benefits:

  • You cannot be denied enrollment into a Medicare Supplement plan
  • You cannot be charged more for the plan based on your age, health status, or pre-existing conditions

If you have pre-existing conditions, your Medicare Supplements carriers may impose a waiting period for coverage which could be as long as six months.

If you opt to enroll in Medigap plans after your open enrollment period, the carrier is allowed to put your application through medical underwriting. This allows them to decide whether or not to accept your application, how much to charge you, and whether or not there will be any coverage restrictions based on your health.

Does Medicare Supplemental Insurance Cover Dental?

Traditional dental coverage for exams, cleanings, fillings, crowns, and bridges is NOT covered by Medicare Supplements or Original Medicare. You can get coverage for dental procedures from a Medicare Advantage policy.

  • Medicare will cover jaw reconstruction if you suffer an accident that directly causes damage to the jaw.
  • A tooth extraction directly due to a disease of the jaw would also be covered by Medicare
  • Medicare Parts A or B will cover a dental exam required due to a complicated surgical procedure depending on who performs the procedure, the hospital or your dentist.

How Can I Compare Medicare Supplement Plans?

Our tool allows you to see the best Medicare Supplement plans comparison chart (for all Medigap plans offered in your state and county). As each plan letter offers the same exact benefits regardless of your location, all you will need to do is decide on which plan letter best fits your needs. Whether you prefer to research your options on your own or just want to compare plan premiums in our Medigap plan finder tool, we have local and licensed agents available to help you. We encourage you to fill out our Request a Call form when you’re ready.

Medicare Supplement Plans Comparison

Each Medigap plan must provide the same benefits, no matter which carrier you choose. For example, Medigap Plan G with carrier X must have the same benefits as Medigap Plan G with carrier Y. So why would you pay a higher premium if carriers have the same coverage? Some plans may use your issue age while others may use your attained age.

Your issue age is based on when you first received coverage whereas attained age is based on your current actual age. If carrier X uses issue age and carrier Y uses attained age, there may be a significant difference in premiums even though they offer the same coverage.

Apart from the premium differences with attained age and issue age, some carriers may offer additional benefits beyond the normal plan coverage. This can include fitness classes, like SilverSneakers and Silver & Fit, or foreign travel emergency coverage. If any of these benefits are important to you, you may have a higher premium.

Medicare Supplement plan comparison is important, and a licensed Medicare agent can help you enroll in the best plan for your needs and budget. They can explain which plans use issue or attained age and make sure you get the best coverage at the best price.

What are the Top 10 Rated Medicare Supplement Carriers in 2019?

As Medicare Supplements are offered by private insurance companies, there can be a lot of carriers to choose from. You know by now that each plan letter offers the same benefits regardless of the carrier and premiums will be determined by where you live.

What else is there to worry about you might ask? Well, anybody that has ever had to deal with them understands insurance carriers can be notoriously difficult. Thankfully, we are not an insurance carrier - we are here to help you. We’ve compiled the following list of highly rated Medigap insurance companies based on how long they have been in business, their business stability, and their combination of low rates, slow rate increases, top notch customer service, and additional benefits (like SilverSneakers fitness programs):

  • Mutual of Omaha
  • Aetna
  • Cigna
  • United American
  • Bankers Fidelity
  • AARP
  • UnitedHealthcare
  • Humana
  • Blue Cross Blue Shield/Anthem
  • TransAmerica

Please keep in mind that each carrier listed above may not offer Medicare Supplement plans in your specific area.

Have Questions? Ask a Benefits Advisor in Your Area

How Much Does a Medicare Supplement Plan Cost?

Medigap plans will require a monthly premium that is separate from your Part B premium. Each letter option comes with different costs. Some have higher deductibles and lower premiums, and some are the reverse. You’ll have to pick the solution that works best for you. Additionally, some Medigap insurance plans have out-of-pocket maximums while others don’t, and some plans cover skilled nursing while others don't. It all depends on your needs.

What is the Average Cost of Supplemental Insurance for Medicare?

Monthly premiums for Medicare Supplement plans can vary greatly depending on which plan you choose and where you live. For instance, the most popular Medicare Supplement Plan F has the most benefits and therefore higher associated costs. Current monthly premiums for a Plan F can range from $111 - $374 depending on the carrier. By comparison, the plan with the fewest benefits, Plan A, has current premiums that range from $60 - $304.

Although all Medigap plans of the same letter provide the same benefits, the costs for those plans within the same location can vary. Insurance providers typically use one of three methods to determine the pricing of their Medicare Supplements in each state county:

  • Community rated: Everybody pays the same rate each month per location regardless of their age.
  • Issue -age-rated: You pay a premium based on the age you are when you sign up for the plan. The younger you are the less you pay. Premiums may increase each year based on inflation but they will increase as you age.
  • Attained-age-rated: Your premiums is based on your age at the time you enroll for the Medigap insurance and it increases every year based on your age and inflation.

Do You Have to Buy Supplemental Insurance with Medicare?

This is a great question that many senior citizens & medicare eligibles have when researching the Medigap plans available to them. Your current health, monthly budget, and any expected or possible future medical procedures will be the first items to make note of. Medicare supplement insurance, in most cases, does not offer more health benefits than those offered by Medicare parts A & B, but it does provide additional financial coverage.

The benefits of Medicare supplement plans are that they help cover your copayments, coinsurance, deductibles, and in some cases foreign travel medical emergency expenses. If you can afford a supplement plan, it might a good idea to enroll. They help with high out-of-pocket expenses and can come in handy if you become ill or injured.

Keep in mind that if you are going to enroll in a Medicare Supplement plan, you should enroll when you are first eligible. Enrolling at the right time will save you money and ensure you get approved for coverage. If you wait, you may be denied coverage or have have higher premiums and an involuntary Medicare waiting period.

How Do I Apply for Medicare Supplement Plans?

The first step to enrolling in Medigap is enrolling in Original Medicare (Part A and Part B) - you cannot have Medigap without having Original Medicare first. Additionally, you cannot have both Medicare Advantage and Medicare Supplement, so if you already have Medicare Advantage and want to switch to Medigap, you’ll need to cancel your Medicare Advantage plan. If you already have Original Medicare and think you may want to add on a Medicare Supplement policy, you can do that during the Annual Enrollment Period (AEP) from October 15 through December 7 each year. If you have a special circumstance (lost or gained a job, moved to a new state, etc.), you may qualify for a Special Enrollment Period (SEP) which will allow you to change or add plans during any time of the year.

When Can I apply for Medicare Supplements?

Initial enrollment period -  This starts three months before you turn 65 and ends three months after your birthday. This is the best time to apply for coverage if you want to avoid a penalty fee and be guaranteed coverage. If you apply for coverage outside of your initial enrollment period, you can be denied coverage or charged more for the plan.

Annual enrollment period (AEP) - Everyone is eligible to apply for Medigap plans from October 15 - December 7

Outside of these two periods you may be eligible to enroll in certain Medigap insurance plans if special circumstances occur, such as:

  • The Medicare Advantage plan you are enrolled in leaves Medicare or stops providing for your area
  • You lose coverage because you moved out of the plan’s service area
  • The Medicare Supplement carrier goes bankrupt or breaks Medicare rules

Feel free to use the best Medicare Supplement Plans comparison tool to find premiums on Medigap insurance.

Medicare Supplements for Disabled People

If you are under 65 and have Original Medicare due to a disability, you should look into whether or not your state requires insurance providers allow you to enroll in Medicare Supplement plans. In many cases the answer will be, “yes!”

Although you will be permitted to apply for Medigap coverage, you may not have access to all the plans and will have to wait until you turn 65 to have a full range of options. Some Medigap insurance plans will be offered by providers to applicants under 65 whether required by law or not, but they may charge more for the coverage, impose waiting periods for coverage, or deny coverage for pre-existing conditions because you are not yet 65.

Medicare Supplements for Low Income Beneficiaries

Many Medicare recipients 65 and over are retired and therefore on limited or low income. Having low income will not prevent you from benefiting from medicare supplement insurance. By carefully evaluating your existing health care costs and comparing them to the monthly cost of a supplemental plan, you may find that the monthly premium would actually help save you money!

Let’s recap. Medicare Supplement insurance helps pay for copayments, coinsurance, and deductibles associated with Medicare Parts A & B. If your monthly medical expenses are more than the monthly premium for a supplement plan, you could benefit from enrolling in Medigap.

One of our licensed and experienced Medicare agents can help you figure out what you’re eligible for and when you can enroll. Set up your free Medicare agent appointment by calling 1-844-431-1832.

Have questions? Ask a Benefits Advisor!