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Complete Guide to Medigap Plans and Coverage
On this page, you can compare Medigap plans in your area and learn what supplemental Medicare insurance covers. Our goal is to help you determine if a Medicare supplement is right for you and find the right plan at the best price available.
Let's start at the beginning.
What is Medigap?
Medicare supplement insurance plans are gap insurance policies (aka, "Medigap") sold by private insurance carriers, not the government. However, the plans are strictly regulated by state insurance regulators.
NOTE: We use the terms Medigap and Medicare supplement interchangeably. They are the two common names for supplemental Medicare insurance (Medicare gap plans).
A Medicare supplement plan can help you pay some of the costs baked into traditional Medicare (Parts A and B), including your co-payments, coinsurance, and deductibles. In most states, there are 10 lettered plans (A-N). Each lettered plan provides a different level of coverage.
Medigap Basic Benefits
Unlike Medicare Advantage plans, which have broad latitude in what they offer, the government decides what benefits each Medicare supplement plan offers. As a result, coverage is the same across all insurance companies. For instance, the basic benefits you’ll receive if you purchase Medicare Supplement Plan F from Humana are the exact same basic benefits you’ll receive from a Blue CrossBlue Shield company. The primary difference between a Plan F from one company vs. another is the monthly premium and how they calculate premium increases.
Medigap Cost Sharing
Original Medicare is a cost-sharing system. The government (The Centers for Medicare and Medicaid Services) pays about 80percent of your major healthcare costs and you pay the other 20 percent. Your 20percent is the coverage gap that Medigap insurance helps you cover. The key to getting the right coverage for your personal needs (i.e., health and financial, is to balance the amount of coverage you need with the cost. An easy way to do that is to use the comparison chart below.
Medigap Plans Comparison Chart
The following 2021 Medicare Supplement Plans Comparison Chart gives a quick look at the benefits provided by each lettered plan (A through N). This is the easiest way to understand what's covered and what isn't.
|Medicare Supplement Plan F and G also offer a high-deductible version. If you choose a high deductible plan, you must pay for all Medicare-covered costs up to the deductible amount of $2,370 before your Medigap plan pays anything.|
|** Medicare Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to $50 copayment for emergency room visits that don't result in an inpatient admission.|
|Medicare Plan K and L have an annual out-of-pocket limit. After you meet your out-of-pocket limit and your yearly Part B deductible, the Medigap plan pays 100% of covered services for the rest of the calendar year.|
Still curious? Click here to learn more about Medigap plans and what they cover.
Best Medicare Supplement Plans
Choosing the best Medicare supplement has everything to do with understanding your own personal health and financial situation. In other words, how healthy are you and how much can you afford. Like all other forms of insurance, Medicare supplements are designed to mitigate risk.
That said, the following plans offer the best coverage:
- Medicare Plan F: This is the Cadillac of plans because it covers everything allowed, including all Medicare deductibles and copayments. However, Plans C and F will no longer be available for new enrollees after 1 January 2020.
- Medicare Plan G: Plan G is almost the same as Plan F. It offers seniors comprehensive coverage and will be the most robust plan available to new enrollees starting January 2020. Unlike Plan F, Plan G requires you to pay the Medicare Part B deductible out-of-pocket.
- Medicare Plan N: This plan has the same overall coverage as Plan G, but you make a $20 copayment when you see your doctor and pay $50 for emergency room care that doesn't require you to be admitted. If you're healthy, this plan offers great savings.
Many seniors getting their Medicare benefits for the first time want to know if Plan G is better than Plan F (or visa versa). It really comes down to overall cost vs. convenience and which is most important to you.
Still curious? Click here to learn more about the Best Medicare Supplement Plans.
What is the Average Cost of Supplemental Insurance for Medicare?
Medigap is a group of standardized plans that help cover the gaps in your Original Medicare health insurance. And, unfortunately, stating an average cost wouldn’t do you much good. Plans cost anywhere from $50 to $300 or more per month, depending on where you live, your age, and the amount of coverage you need.
A better question to ask might be how much coverage can I get that I can afford? Or, how can I save money on a Medicare supplement plan and still be covered for my major medical costs?
Still curious? Click here to discover more about What is the Average Cost of Supplemental Insurance for Medicare?
Medicare Plan F vs Plan G
With Medicare Supplement Plan F no longer available to people turning age 65, a lot of folks are wondering what they are missing out on. And the fact of the matter is, not much.
The only difference between these two Medigap plans is who pays the annual Medicare Part B deductible, you or your insurance company. The reason Plan F going away isn't a big deal is that most people with a Plan G save a little money overall. And, that makes sense, doesn't it? If you write the check out of your own pocket, you save. If you make the insurance company write the check, you pay more. Either way, the deductible gets paid.
Still curious? Click here to learn more about Medicare Plan F vs Plan G.
Is Medicare Plan G Better Than Plan F?
Is one plan better than the other? That depends on if you’re looking for the lowest overall cost or the policy that is most convenient.
Medicare Supplement Plan F covers the following gaps:
- Medicare Part A Coinsurance & Hospital Costs
- Medicare Part A Skilled Nursing Facility Coinsurance
- Medicare Part A Deductible (per benefit period)
- Medicare Part A Hospice Care Coinsurance or Copayment
- Medicare Part B Deductible (annual)
- Medicare Part B Coinsurance or Copayment
- Medicare Part B Excess Charges
- Blood (first 3 pints)
- Foreign Travel Emergency
In case you are wondering, that’s the most coverage you can get with a Medicare supplement. In fact, that’s first-dollar coverage, which means you don’t pay anything out-of-pocket to see your doctor, visit the emergency room, or if you’re admitted into the hospital, so long as all charges are Medicare-approved.
Unfortunately, Plan F isn't available if you are turning age 65 this year. That means Medicare Supplement Plan G is the best plan available to new Medicare beneficiaries.
Still curious? Click here to learn even more about how Medicare Plan G Better than Plan F.
What is the Best Medicare Supplement Insurance Plan?
Just above we said that Plan F offers the most coverage available in a Medicare supplement. So, is there really anything left to discuss?
Yes, there is.
You see, it all comes down to your definition of best.
For some, the question of best means getting the most coverage. Medigap Plan F offers the most coverage possible. It covers ALL the cost gaps in Original Medicare (Part A and Part B). But, Plan F is no longer available to new Medicare beneficiaries. As a result, Medigap Plan G is the next best available.
Many of us find ourselves on a fixed budget. At the same time, we may be healthy or simply have a chronic condition that’s easily managed through medication. For these people, Plans F and G might be too expensive or simply wasteful. In this case, Plan N could be the best option.
Still curious? Click here to discover even more about getting the best Medicare supplement insurance plan for your personal situation.
Medicare Supplement Open Enrollment
It’s easy to be fooled into believing that open enrollment for Medicare supplement insurance is in the fall. That’s because Medicare itself puts out so much information about the Annual Election Period (AEP), which starts each October 15th and ends December 7th.
Medigap plans do not have an annual open enrollment period and are not included in the fall AEP where you are free to switch Medicare Advantage and Part D (prescription) plans no matter what. The reason for this is that Medicare supplements do not have the same protections as Medicare Advantage and Medicare Part D plans. You are free to compare Medigap plans and make changes whenever you want.
Still curious? Click here to discover more about Medicare Supplement Open Enrollment and the dates that are important to remember.
What is a Medicare Supplement Plan?
A Medicare Supplement plan is additional insurance that works in conjunction with Medicare Part A and Medicare Part B benefits. There are 10 standardized plans, A to N. Each lettered plan offers a different level of coverage to suit a variety of needs. You probably know all of that already. But, did you also there's a Medicare Select plan?
Before Medicare Advantage was available, Medicare Supplement insurance companies contracted with local hospitals and doctors to get more favorable rates. These unique plans became known as Medicare SELECT policies.
Although Medicare SELECT policies are not available everywhere, where available they offer big savings. In trade for the savings, policyholders agree to use the local providers specified by the policy, just like Medicare Advantage plans.
Are Medicare Supplement Plans Worth It?
Original Medicare offers basic health insurance coverage. For most people, it takes care of about 80 percent of all major medical bills. For the remaining 20 percent, you must pay out of your own pocket or purchase additional insurance. So, let's explore further if supplemental Medicare insurance is worth the cost.
Without a Medigap plan to supplement your basic Medicare coverage, a chronic illness, injury, even a short stay in the hospital, will run your medical bills into the thousands. A critical illness, like cancer or heart disease, could end up costing you your home, cash savings, or both.
Unless you are already poor, the Government will not give you additional assistance to help pay your medical bills, no matter how big they grow. This is why having additional insurance, to fill the gaps created by Medicare, is so important. That's what Medicare supplement insurance does for you. It pays some or all of the major medical bills that Medicare doesn't pay.
Still curious? Click here to discover even more related to are Medicare supplement plans worth it?
Do I really Need Supplemental Insurance with Medicare?
If you’re just now getting your Medicare benefits for the first time, you might be wondering, are Medicare supplements worth the cost?
Unfortunately, many people are shocked to learn that Medicare does not cover all costs when they retire. From the beginning, Medicare has been a shared-cost system with the government paying 80 percent and the beneficiary paying the other 20 percent of all major medical costs.
Without additional coverage, you will pay all of your 20 percent share out-of-pocket. Simply put, if you don’t have supplemental Medicare insurance or a Medicare Advantage plan, you could find yourself tens of thousands of dollars in debt due to an accident or a chronic illness.
Another aspect of both Original Medicare and Medicare Advantage that surprises people s that they do not cover you if you need emergency care while traveling outside of the United States and its territories. Medicare supplement insurance does.
Still curious? Click here to discover more about why most people need supplemental insurance with Medicare.
Medicare Supplement Plans With No Premiums
If you are looking for a Medicare supplement plan that does not have a premium, get in line. They don't exist, and they never will.
Why not, Medicare Advantage plans are available with no additional premium?
Medicare has four parts:
- Part A: Original Medicare Hospital Insurance
- Part B: Original Medicare Medical Insurance
- Part C: Private Health Insurance (Medicare Advantage)
- Part D: Private Prescription Drug Insurance
Medigap plans work with Part A, Part B, and Part D of Medicare only, but Medigap plans are not offered by the government and they are not funded by the government. Medigap is private insurance.
Still curious? Click here to get more information on Medicare supplement plans with no premiums.
Medicare Supplement Plans for Disabled Under 65
If you’re under the age of 65 and you qualify for Medicare benefits due to a disability or End-Stage Renal Disease (ESRD), you may or may not be able to purchase Medicare supplement insurance plans. It all depends on where you live.
Each state has its own set of rules regulating the sale of Medicare supplements. Even though Federal law has a nation-wide Medicare guaranteed issue right protection, it does not mandate that insurance companies must sell policies to people under the age of 65. To date, there are just 29 states that do require insurers to sell Medicare supplements to people who are eligible for Medicare, regardless of their age.
Still curious? Click here to get more information on Medicare supplement plans for the disabled under age 65, including the 29 states that mandate coverage.
Can I Change Medicare Supplement Plans Anytime?
Unlike Medicare Advantage and Medicare Part D, there isn’t an open enrollment period for Medicare supplements. That’s good news.
The bad news is that switching plans often means you must pass medical underwriting for approval. However, you can make these changes any time of year.
Still curious? Click here to learn more about how to change Medicare supplement plans anytime you want.
Medicare Supplement Guaranteed Issue
If you want to change your Medigap plan, or if you will be enrolling for the first time, you should know about very important protection granted to you by law. It is your guaranteed-issue right.
Medicare supplement guaranteed-issue is a right granted to Medicare beneficiaries and applies to all supplemental Medicare insurance. All states and the federal government enforce this essential right, which protects you from medical underwriting.
Unlike regular health insurance, supplemental Medicare insurance companies can use your health history and data on pre-existing conditions to make their coverage determination. In other words, you can be turned down due to a pre-existing condition. However, you have a very narrow window of time when you first qualify for Medicare where you have a right to get insurance without any questions.
Still curious? Click here to discover what you need to know about your Medicare Supplement Guaranteed Issue right.
How to Choose a Medicare Supplement Plan
Original Medicare provides good health insurance coverage for your major medical, but it doesn’t cover everything. However, you have the option to fill most of the coverage gaps by purchasing a Medicare supplement plan.
While it might initially seem complicated, if you follow our five-step plan, you’ll be well on your way to secure the coverage you need. Our How to Choose a Medicare Supplement Plan guide will walk you through the five steps.
How Much Do Medicare Supplement Plans Cost?
For most seniors comparing Medicare supplement plans, the cost is the primary consideration. Monthly premiums for supplemental insurance plans are not regulated, so what you pay is completely dependent on the plan you choose (e.g., Plan A, B, C, etc.) and the insurance company you contract with.
Medicare supplemental insurance companies are allowed to establish premiums. They do so based on actuarial formulas. As a result, plan costs vary. In other words, if you are shopping for a Plan F policy, the same plan from company A may cost less than it does from company B, even though both Plan F policies provide the exact same benefits.
Still curious? Click here to learn more about how much Medicare supplement plans cost.
How Do I Get a Medigap Plan?
Medigap plans are supplemental insurance policies purchased through insurance carriers licensed in your state. The first step is to shop policies available in your state.
The good news is that Medicare Supplements are standardized using letters A through N. This means that a Medigap Plan A or Plan F sold by one insurance carrier is exactly the same as another. The only difference is the monthly premium.
Be a savvy senior and shop around and review your plan annually to make sure you're still paying a competitive rate.
Where Do I Buy a Medigap Plan?
You can purchase a Medicare supplement policy from a licensed agent or directly from the insurance carrier. An independent agent can help you compare policies from multiple carriers. You can locate agents in your state here.
For more information about Medigap plans, visit this page on Medicare.gov.
Frequently Asked Questions About Medigap Plans
If your definition of the best is most coverage, then Medigap Plan F is the best you can get. But, there are many factors that you should consider, including your financial goals and your health. Many healthy seniors can afford to take a little risk. In this situation, Medigap Plan N is an excellent way to save money. Also, if you are turning age 65 in 2021, Medigap Plan G is the best plan you can get. Find and compare plan options here.
Although Medigap Plan F is the most comprehensive Medicare supplement plan, it may not be the most cost-effective. Plan F covers Medicare deductibles and all copays and coinsurance, which means you pay nothing out of pocket for your Medicare-covered services. However, many healthy seniors find that they save more money with a Medigap Plan N policy. On this page, you can compare plans and get a no-obligation analysis of all plan costs, from all insurance carriers, in your area.
The differences between Medigap plans are the gaps they cover. With Original Medicare (Part Aand Part B) you pay various deductibles, copays, and coinsurances when you use health care services. These costs generally add up to about 20% of the overall cost. That's not so bad for one or two doctor visits each year, but what about a stay in the hospital? This Medicare Supplement Comparison Chart will give you a visual comparison of the differences in Medicare supplement plans, or you can compare Medigap plans here.