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In all but 3 states, there are 10 standardized Medicare Supplement plans, identified by letters A – N. Each plan covers different gaps in Original Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage. coverage, including A deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share., A copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service., and Coinsurance is a percentage of the total you are required to pay for a medical service. .
Standardization makes comparing plans easier. Once you know the amount of additional coverage you need with your Medicare benefits, you can focus on finding the best rate and insurance company.
Medicare Supplement Plan Comparison Chart
The lettered plan system makes comparing Medicare Supplement plans easy. The following chart shows you the different Out-of-Pocket Costs for Medicare are the remaining costs that are not covered by the beneficiary's health insurance plan. These costs can come from the beneficiary's monthly premiums, deductibles, coinsurance, and copayments. in Medicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care. and Part B (left). The columns to the right show how each plan covers the costs.
What is Medicare Supplement Insurance?
Medicare Supplements are additional insurance policies that Medicare beneficiaries can purchase to cover the gaps in their Original Medicare (Medicare Part A and Medicare Part B) health insurance coverage., also called Medigap, is a type of indemnity health insurance policy that helps you pay your share of Medicare costs.
Original Medicare, which consists of hospital coverage (Part A) and medical coverage (Part B), only pays about 80% of your major medical costs. Medicare beneficiaries are responsible for the other 20%.
These costs are paid through deductibles, copayments, and coinsurance when you use healthcare services. Medigap plans help cover those costs.
Choosing the best Medigap plan is all about balancing the amount of coverage you need with what you can afford. If you asked your insurance agent, "What is the average cost of Medicare Supplement insurance," and got turned off by the cost, you probably got quoted Plan G rates only.
What are the Costs for Medigap Plans?
Medigap insurance policies are sold by private insurance companies. Costs vary based on the amount of coverage, the company, and other factors.
Factors that influence policy costs the most include:
- Your age
- Your gender
- Your location
- Your use of tobacco
- When you apply
We offer a free service to help you get rates from all insurance companies that sell plans in your area.
What is the Best Medicare Supplement Plan in 2023?
When it comes to Medicare Supplements, “best” is a relative thing. What’s best for you may be completely different than what’s best for your spouse or your neighbor.
We’re all different and so are our health insurance needs. Let’s discuss what might be best for you.
When “Best” Means “Most Coverage”
The two plans with the most coverage are Medicare Supplement Plan F is the most comprehensive Medicare supplement plan available. This plan covers all Original Medicare deductibles, coinsurance, and copayments, leaving you with no out-of-pocket costs on all Medicare-approved services. and Plan G. However, Plan F is not available to everyone.
Plan F covers all out-of-pocket costs on Medicare-approved services, supplies, and equipment. It is available to people who qualified for Medicare before 2020.
Plan G covers all out-of-pocket costs except the Medicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare services. annual deductible. But, the annual cost difference between a G and F policy is generally more than the Part B deductible. Most people save money with a G policy.
When “Best” Means “Good Coverage with Great Savings”
If you are a relatively healthy individual, a Plan F or Plan G policy may be too much insurance. And too much insurance wastes money.
Most healthy people see their doctor for their annual checkups or when they’re sick or injured. Medicare pays 100% of your Medicare's annual wellness visit is a preventative care service provided to its beneficiaries at no cost. The annual wellness visit is available every twelve months after the beneficiary's initial "Welcome to Medicare" preventative visit., including your vaccines.
For healthy people, having coverage on the Medicare Part B deductible and Part B excess charges isn’t necessary. And, full coverage on the Part B coinsurance is overkill, too.
Healthy people can find healthy savings with Medicare Supplemental Plan N is one of the ten standardized Medigap plans. Although it is one of the newest plans available, Medicare Plan N is quickly becoming a favorite with Baby Boomers aging into their.... This plan covers all of the big costs, including the Part A inpatient deductible, skilled nursing facility coinsurance, blood, foreign travel emergencies, and more.
What Plan N does not cover are all Part B medical costs. It does not pay any of the Part B deductible or A Medicare Part B excess charge is the difference between a health care provider’s actual charge and Medicare’s approved amount for payment.. But it does pay most of the Part B coinsurance.
If you have a Plan N policy you pay a $20 copayment to see your doctor. You also pay a $50 copayment for emergency room visits.
What you get when you pick up these Part B costs out-of-pocket is a much lower monthly premium. Plan N A premium is an amount that an insurance policyholder must pay for coverage. Premiums are typically paid on a monthly basis. In the federal Medicare program, there are four different types of premiums. are generally 25% to 30% less than Plans F and G.
When “Best” Means “Affordable Coverage with Some Risk”
If an N policy isn’t affordable for you, and you can’t stomach the idea of a Medicare Advantage plan, a plan with an annual out-of-pocket limit might be the right option. That’s what Plan K and Plan L offer.
Plans K and L cover 50% or 75% of your costs, respectively, until your out-of-pocket costs on Part A and Part B services reach the annual limit (see chart). Once you reach the annual limit in a calendar year, the plan kicks in to pay all Part A and Part B costs.
Plan K premiums are typically around half as much as N. Plan L doesn’t save nearly as much as K, but premiums 20-30% lower than N are common.
When you consider that the average Medicare Advantage health plan out-of-pocket maximum is in excess of $5,000 per year, and you are restricted to the plan’s provider network, these plans are not a bad alternative.
When “Best” Means “Lower Premiums”
If you want lower premiums, and the idea of paying for most of your regular medical care out-of-pocket doesn’t concern you, look at a high deductible plan.
Once you pay the annual deductible, High Deductible Plan F is a version of the regular Medigap Plan F. You pay all costs until spending reaches the annual, then the plan pays all Medicare-approved costs. and The high deductible version of Medicare Supplement Plan G has the same coverage benefits as the regular Medigap Plan G, but you pay all costs until your Medicare-approved costs reach the annual deductible. High Deductible... work exactly like the regular F and G policies. The deductible on these plans in 2023 is $2,700.
In most areas, these plans cost about the same as a Plan K policy. And, even though you pay all inpatient, outpatient, and emergency care costs until you reach the deductible, many experts feel it’s a better way to go than a shared-cost plan.
The cost difference between a regular G and a High Deductible Plan G is between $75 and $125 per month. This is causing many new Medicare beneficiaries to put what they can save in the bank and self-insure.
What does that mean?
Let’s suppose you’re a non-smoking woman living in Tampa, Florida turning 65 this year. Your Plan G rates will start at around $171 per month (as of 1/1/2023). But your HD Plan G rates start at about $46 per month.
That’s a difference of $125 per month or $1,500 per year. After 5 years, that adds up to $7,500.
What if you put that monthly premium difference in a savings account and use it for your out-of-pocket costs? Would you be ahead? It all depends on your healthcare needs.
What About Plans A, B, C, D, and M?
Medicare Supplement Plan A is often confused with Medicare Part A, which is the Medicare coverage that pays for your inpatient hospital care. Medicare Supplement Plan A, which is also known as Medigap Plan A,... and Plan B are basic benefit plans that cover Part A and Medicare Part B coinsurance. However, in most areas of the country, they don’t make any sense cost-wise. This is particularly true when you compare their rates to Plan N. And, Plan A doesn’t cover the Medicare Part A deductible, which is a pretty big hit.
Plan C is an excellent plan. However, like Plan F it covers the Part B deductible. As a result, it is not available to new Medicare beneficiaries. G is a better option for most people because it covers Part B's excess charges. Plan C doesn’t.
Plan D has similar coverage to Plan C, but doesn’t cover the Part B deductible. Plus, in most cases, it costs the same or more than Plan G.
Plan M is a cost-sharing plan like Plan N. Only, instead of sharing part of your doctor's office visit costs you’re sharing half of the Part A deductible. That’s a much bigger risk than $20 copays to see your doctor. Plus, Plan M costs 20-30% more.
What About Medicare SELECT Plans?
Medicare SELECT is a type of Medigap policy (Medicare supplement plan) that requires its members to get their primary care from a contracted provider. plans are Medicare Supplements with a provider network. This plan type, which isn’t available everywhere, usually requires you to use a specific hospital to receive your primary care for Medicare-covered services.
Due to the contracts plans have with local hospitals, they generally offer good savings for their policyholders.
Who Is Eligible for a Medicare Supplement?
Anyone age 65 and older who is enrolled in both Medicare Part A and Medicare Part B is eligible to apply for a Medigap plan.
In some states, people under the age of 65 who qualify for Medicare through Social Security disability, may also be eligible for Medicare Supplement insurance plans. It all depends on the state and the availability of insurance companies offering coverage.
There are 11 states that require insurers to offer at least one Medigap plan option to people under the age of 65. State regulations vary in terms of plans that must be offered and whether plans can charge higher premiums. The states include Arkansas, California, Connecticut, Maryland, New Jersey, North Carolina, Oklahoma, Texas, Michigan, Indiana, and Virginia.
12 states and DC do not require coverage, but some coverage is available. The states include Alabama, Alaska, Rhode Island, Utah, West Virginia, Iowa, Nebraska, New Mexico, North Dakota, South Carolina, Washington, and Wyoming.
Four states, including Arizona, Kentucky, Nevada, and Ohio have not enacted any provisions to ensure access to supplemental health insurance coverage for people under age 65. And, there are no companies offering plans.
Federal bills to mandate guaranteed access have stalled in Congress, including HR1394.
When to Enroll in Medicare Supplement Insurance
The best time to get Medicare Supplement insurance is when you first qualify. This is when you have certain Medigap protections, including a guaranteed issue right.
When you initially enroll in Medicare Part B, your Upon initial enrollment in Medicare Part A and Part B, beneficiaries have a one-time, six-month period to buy a Medicare supplement policy with guaranteed issue rights. This is the Medigap Open Enrollment Period. begins. This is a six-month period of time that starts the month your Part B benefits begin.
During this period of time, you can buy any Medigap policy you want. You cannot be turned down, even if you have A pre-existing condition is any health problem that occurred before enrolling in a health plan. The Affordable Care Act law made it illegal for health plans to or charge more due to a pre-existing condition...., and you are not required to answer health questions.
Once your Medigap During the Medicare Open Enrollment Period, Medicare Advantage and Part D plan members can change, switch, or drop a plan they chose during the Annual Election Period. OEP starts on January 1 and ends on March 31. ends, you no longer have Guaranteed-issue is a right granted to Medicare beneficiaries and applies to Medicare Supplement insurance (aka, Medigap plans). All states and the federal government enforce this essential right, which protects Medicare beneficiaries from medical underwriting.. That means companies can refuse to issue you a policy. They also have the right to ask you questions about your health.
Do Any Medigap Plans Have Extra Benefits?
In the past, Medicare Supplement insurance was allowed to offer extra benefits, such as prescription drug plans. The Medicare program has phased out all Medigap plans with additional coverage benefits.
Today, only Medicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B). have the option to add additional benefits, like dental, vision, and hearing. But you can add a Medicare Part D plans are an option Medicare beneficiaries can use to get prescription drug coverage. Part D plans provide cost-sharing on covered medications in four different phases: deductible, initial coverage, coverage gap, and catastrophic. Each... plan to get prescription coverage.
Medicare Supplement vs Medicare Advantage Pros and Cons
If you are looking to supplement your Medicare coverage, it makes sense to compare the Medicare Supplement vs Medicare Advantage pros and cons. Here's the primary difference you need to know about.
A Medicare Advantage plan replaces your Original Medicare benefits (Part A and Part B) with private health insurance. Plans may or may not offer more healthcare services, such as a Medicare prescription drug plan, dental, and vision. However, what most of these plans don't is cover more of your major medical out-of-pocket costs.
Instead, they cap your annual costs with an out-of-pocket maximum. But, these maximums can be very high.
Are Medicare Advantage plans bad? No. They simply don't give you more coverage on the biggest risk most of us have, our hospital costs.
Medicare Supplement insurance doesn't add more benefits, it adds more coverage on your out-of-pocket costs. This is one of the disadvantages of Medigap plans. However, they address hospitalization costs head-on.
Compare Medicare Supplement Plans in Your State
Citations and References
- What's Medicare Supplement Insurance (Medigap)? | Medicarehttps://www.medicare.gov/supplements-other-insurance/whats-medicare-supplement-insurance-medigap
- How to compare Medigap policies | Medicarehttps://www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policies
- Welcome to Medicare | Medicarehttps://www.medicare.gov/