Understanding Medicare Supplements
The Difference Between Medicare Advantage and Medicare Supplements
You may hear Medicare Supplements referred to as “Medigap insurance plans.” That is because these Medicare plans can help “close the gap” between what you need to pay and what you have coverage for. Instead of providing additional health benefits, Medigap plans cover your out-of-pocket Medicare costs.
There are ten types of Medigap plans, organized by letters A, B, C, D, F, G, K, L, M, and N (see our Medicare Supplement plans comparison chart below or click on the letters in the below section to read about each individual plan type). 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 G is one of the most popular Medicare supplement plans. Benefits include the Part A deductible, coinsurance, and hospice/hospital costs, Part B coinsurance/copayments and excess charges, blood (up to three pints), skilled nursing facility coinsurance, and some foreign emergency travel. You’ll notice that Plan G does not cover the Medicare Part B deductible. This is the only difference between Medicare Plan F and Plan G. Plan F is going away next year, so Plan G is going to be the best alternative for most people.
Medigap plans F and G are easily the two most popular Medicare Supplements, but as of January 1, 2020, Medicare Supplement Plan F will be discontinued - as well as Plan C. The reason for this is that both Plan F and Plan C cover the Part B deductible. Congress discovered that all-inclusive plans (like plans F and C) were encouraging people to visit the doctor TOO often, because it was practically free. In doing this, people were costing doctors and the government a lot of money for unnecessary doctor visits. By ensuring that people do have to pay the Part B deductible first, unnecessary visits can be prevented. But, don’t worry - the Part B deductible is only $185 in 2019! If you already have a Medicare Supplement Plan F or Plan C prior to the cut off date you will not lose your plan, but your premium may increase.
Plans A through D have a lot of similarities. All four options cover Part A coinsurance and hospital costs, Part A and B coinsurance and copayments, and the first three pints of blood. None of the four have an out-of-pocket maximum.
After that, the plans start to differ. Plans C and D will cover skilled nursing facility coinsurance, but Plan A and Plan B will not. Plans B, C, and D will cover the Part A deductible, but Plan A will not. Plan C is the only plan of the four that will cover the Part B deductible, but Plan D is the only one that will cover Part B excess charges. Finally, Plans C and D will cover up to 80% of foreign emergency travel, but Plans A and B will not cover any of it.
Keep in mind that, as mentioned above, Plan C will be going away next year due to its Part B deductible coverage.
All four of these plans cover Medicare Part A coinsurance and hospital costs, but the similarities end there. While Plans N and M provide full coverage for Part B coinsurance and copayments, the first three pints of blood, Part A hospice coinsurance and copayments, and skilled nursing facility coinsurance, Plan L only covers 75% of the above and Plan K only covers 50%.
Additionally, Plan N covers the Part A deductible in full, but Plan M and K only cover 50% and Plan L covers 75%. Plans M and N cover 80% of foreign emergency travel, but Plans K and L don’t cover it at all.
Medicare Supplements are often confused with Medicare Advantage, but they are two vastly different types of coverage. While Medicare Advantage is a way to add health benefits (dental, vision, prescription drugs, etc.) to your plan, Medicare Supplements are a way to add financial benefits (help paying for your copayments, coinsurance, and deductibles). In some cases, Supplements might cover “small” health benefits, like Medicare fitness programs, but they are usually exclusively financial. If you’re looking for additional health benefits, you’ll want Medicare Advantage instead (you cannot have both Medicare Advantage and a supplement plan).
If you apply during your Medicare 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 that you cannot be denied Medicare Supplement enrollment nor can you be charged more based on your age, health status, or pre-existing conditions. However, if you do have pre-existing conditions, carriers can impose up to a six-month waiting period before your benefits begin.
If you wait too long to enroll and you are outside of your Initial Enrollment Period, carriers can put your application through “underwriting.” This means that they can decide whether or not to accept your application, how much to charge you, and whether or not you will have any coverage restrictions based on your age, health status, and pre-existing conditions.
In most cases, Medicare Supplement plans do not cover prescription drugs. For prescription coverage, you'll want to look into either a Part D plan or a MAPD plan (a Medicare Advantage plan with prescription drug coverage). One way to save on prescriptions is to download a free prescription drug savings card. It is not insurance and you do not need prescription insurance to use it.
Traditional dental coverage for exams, cleanings, fillings, crowns, and bridges is NOT covered by Medicare Supplements. You can get coverage for dental procedures from certain Medicare Advantage policies. If you don’t enroll in Medicare Advantage, the only dental benefits that Original Medicare (parts A and B) provides are the following:
Each Medigap plan must provide the same benefits, no matter which carrier you choose. For example, Plan G with carrier X must have the same benefits as Plan G with carrier Y. So why would you pay a higher premium if each Carrier’s plan covers the same costs? Two reasons:
Issue age vs. Attained age
Your issue age is how old you were when you first received Medicare coverage, but your attained age is your current age. If carrier X uses issue age and carrier Y uses attained age, there may be a significant difference in premiums even though the coverage is the same.
Additional health benefits
Some carriers may offer additional benefits beyond the normal plan coverage. Additional health benefits are much more common to find in Medicare Advantage plans, but some Medigap plans add a few health benefits to attract more clients. One of the most common additional health benefits for a Medigap plan to include is physical fitness through programs like SilverSneakers and Silver & Fit. If any of these benefits are important to you, you may have a higher premium.
Medicare Supplement plan comparison is important, and a licensed 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.
Our plan finder 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 Medicare Supplement 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.
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 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.
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 and your location. By comparison, the plan with the fewest benefits, Plan A, has 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:
As Medicare Supplements are offered by private insurance companies, there can be a lot of carriers to choose from. Unfortunately, not all plans and carriers are available in every area. A licensed agent can provide you with information for the top rated Medicare Supplement carriers in 2019 that are available to you.
The first step is to enroll in Original Medicare (Part A and Part B) - you cannot have Medigap insurance plans without having Original Medicare first. Additionally, you cannot have both Medicare Advantage and a Medicare Supplement plan, so if you already have Medicare Advantage and want to switch to Medigap, you’ll need to cancel your Medicare Advantage plan.
This is a great question that many senior citizens & Medicare eligibles have when researching the Medicare 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 be 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 higher premiums and an involuntary Medicare waiting period.
If you already have Original Medicare and think you may want to add on a Medicare Supplement policy, you can do that during your Initial Enrollment Period (when you first become eligible for Medicare). You can technically purchase Medigap during any time of the year, but your Initial Enrollment Period is when it is going to be the cheapest and easiest to enroll, and is the only time when you cannot be denied based on pre-existing conditions.
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.
There are hundreds of disabilities that are automatic qualifiers for Medicare Advantage Chronic Special Needs Plans. You do not have to be 65 to qualify for these plans as long as your disability is a qualifier. You can read more about whether or not you qualify and about why you should enroll in a CSNP, here.
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 cover your 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 may benefit from enrolling in Medigap.
One of our licensed and experienced agents can help you figure out what you’re eligible for and when you can enroll. Set up your free, no-obligation appointment by clicking here or calling 833-438-3676.
By providing the information above, I grant permission for Medicare Health Benefits Independent Broker, MedicarePlanFinder.com, and its affiliated agencies to contact me to discuss Medicare Advantage, Prescription Drug Plans, or Medicare Supplement products. Not affiliated with or endorsed by Medicare or any government agency.