Medicare Supplements

Medicare supplement plans, also known as Medigap plans, are insurance plans that are designed to fill in the “gaps” in original Medicare coverage. These plans are sold by private insurance companies and can help cover costs such as copays, coinsurance, and deductibles that original Medicare does not cover. There are 10 standard Medigap plans available, each labeled with a letter (for example, Plan A, Plan B, Plan C, etc.). The benefits and coverage provided by each plan are standardized by the federal government, so Plan A from one insurance company will have the same benefits as Plan A from another insurance company. However, the cost of the plan can vary by insurer. Medigap plans can be used in conjunction with original Medicare to provide additional coverage.

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Medigap Plan A

Medigap Plan A is one of the 10 standardized Medigap plans available in the United States.

Medigap Plan A provides coverage for the following:

  • Part A hospital coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up.
  • Part B coinsurance or copayment
  • First 3 pints of blood used in a medical procedure
  • Hospice care coinsurance or copayment

 

Medigap Plan A does not cover certain benefits such as the Part A deductible, skilled nursing facility care, and foreign travel emergency.

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Medigap Plan B

Medigap Plan B is a type of supplemental insurance plan that is designed to cover some of the out-of-pocket expenses that are not covered by Original Medicare (Parts A and B). These expenses include things like deductibles, coinsurance, and copayments. Medigap Plan B typically covers the same benefits as Medigap Plan A, but it also includes coverage for the Medicare Part A deductible. 

What isn’t covered by Medigap Plan B?

  • Skilled nursing facility care coinsurance
  • Foreign travel exchange
  • Part B deductible
  • Part B excess charge

Medigap Plan C

Medigap Plan C is a type of supplemental insurance plan that is designed to cover some of the out-of-pocket expenses that are not covered by Original Medicare (Parts A and B). These expenses include things like deductibles, coinsurance, and copayments. Medigap Plan C typically covers the same benefits as Medigap Plan A and B, but it also includes coverage for the Medicare Part A and B deductibles, and also foreign travel emergencies.

Medigap Plan D

Some of the specific benefits that Medigap Plan D covers include:

  • Medicare Part A deductible
  • Medicare Part B deductible
  • Foreign travel emergency
  • Skilled Nursing Facility care coinsurance (in some states)

Medigap Plan D does not cover prescription drugs. If you want coverage for prescription drugs, you’ll need to enroll in a separate Medicare Part D plan. Even though it is easy to confuse Medigap Plan D and Medicare Part D, please have in mind these are two separate and very different plans.

It’s also important to note that Medigap Plan D does not cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing. Part B excess charges are also not covered by this Medicare Supplement plan.

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Medigap Plan F

Medigap Plan F typically covers the following benefits:

  • Medicare Part A hospice care coinsurance or copayment
  • Medicare Part A deductible
  • Medicare Part B coinsurance or copayment
  • Blood (first 3 pints)
  • Medicare Part B deductible
  • Skilled Nursing Facility care coinsurance
  • Foreign travel emergency
  • Preventive care Part B copayment

Whatever is not covered by Original Medicare, in general, is not covered by Plan F either. This includes things that are cosmetic in nature, treatments for infertility, and other generally routine services like:

  • Routine vision and foot care
  • Most dental care
  • Acupuncture
  • Hearing aids and exams

Medigap Plan F is considered the most comprehensive Medigap plan and offers the most extensive coverage among the other Medigap plans. Due to a change in federal law, people who have become eligible for Medicare after December 31, 2019. do not qualify for Plan F anymore. However, Plan F continues to be available to everyone who became eligible for Medicare before that date. 

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High Deductible Plan F

High Deductible Plan F has a high deductible, which means that the policyholder will be responsible for paying a certain amount of out-of-pocket costs before the insurance coverage kicks in. Once the deductible is met, the insurance plan will cover the remaining costs for covered services. This plan is usually less expensive than traditional Medigap plans, but it may require policyholders to pay more out-of-pocket costs before the coverage begins.

 

Some benefits of Medigap High Deductible Plan F include:

  • Coverage for Medicare Part A and Part B deductibles, coinsurance, and copayments: Once the high deductible is met, this plan will cover the remaining costs for covered services, helping to protect policyholders from high medical expenses.
  • Lower monthly premiums: Because Medigap High Deductible Plan F has a high deductible, the monthly premiums for this plan are generally lower than traditional Medigap plans.
  • Guaranteed issue rights: Medigap plans are guaranteed issue, which means that insurance companies must sell Medigap coverage to individuals who are 65 years or older and enrolled in Medicare Part B, regardless of their health status.
  • No network restrictions: Medigap plans do not have networks, so policyholders can see any doctor or hospital that accepts Medicare.
  • No referrals required: Policyholders do not need a referral to see a specialist with Medigap.

In 2023, the deductible for this plan will be $2700. It is important to mention though that Medigap High Deductible Plan F is not available for purchase in some states.

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Medigap Plan G 

Medicare Supplement Plan G is one of the best options out of all Medigap plans for all Medicare enrollees because it is the most comprehensive plan for new Medicare beneficiaries. Signing up for this plan will significantly lower your out-of-pocket costs compared to what they would be with Original Medicare only. 

After you carry out the annual deductible, your coverage will be 100% for all of the additional medical costs in that year that will be listed below. Medigap Plan G covers many of the out-of-pocket costs not covered by Original Medicare, including

  • Part A hospital coinsurance and up to 365 additional days of coverage after Original Medicare benefits are used up
  • Part A hospice care coinsurance or copayment
  • Part B coinsurance or copayment
  • The first three pints of blood used in a medical procedure
  • Part A and Part B deductibles
  • Part B excess charges (except for certain states)

 

Medigap Plan G does not cover:

  • The Part B annual deductible
  • Long-term care
  • Vision, hearing or dental care
  • Private-duty nursing
  • Prescription drugs
  • Any other expenses not covered by Original Medicare
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High Deductible Plan G 

High Deductible Plan G is a type of Medicare Supplement plan that has a high annual deductible before coverage begins. The annual deductible for High Deductible Plan G is $2,700 in 2023, which is higher than the deductibles for other Medigap plans. However, the monthly premium for High Deductible Plan G is typically lower than other Medigap plans.

Once the annual deductible is met, High Deductible Plan G covers the same benefits as regular Plan G. These benefits include:

  • Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
  • Medicare Part B coinsurance or copayment
  • Blood (first 3 pints)
  • Hospice care coinsurance or copayment
  • Skilled nursing facility care coinsurance

Like all Medigap plans, High Deductible Plan G does not cover prescription drugs. If you need coverage for your medications, you may need to purchase a separate prescription drug plan (Part D).

It’s important to weigh the pros and cons of High Deductible Plan G and compare it to other Medigap plans to see which one best fits your needs and budget. 

Medigap Plan K 

This Medicare supplement plan is not as comprehensive as some other supplement plans but it is good if you don’t mind cost-sharing.

Medigap Plan K coverage

This plan offers are

  • 100% Medicare Part A coinsurance hospital costs for 365 additional days
  • 100% of Medicare Part B preventive care coinsurance
  • 50% of Medicare Part B coinsurance or copay
  • 50% of Part A hospice care and copay
  • 50% of the first three blood prints
  • 50% of skilled nursing facility care coinsurance
  • 50% of Medicare Part A deductible

What Plan K Doesn’t Cover For?

  • Medicare Part B deductible
  • Medicare Part B excess charges
  • Foreign travel emergency

Medicare Supplement Plan K has an annual out-of-pocket limit which amounts to 6,940$ in 2023, but it is subject to change every year. If you reach this limit before the end of a year, your supplement plan needs to cover your additional expenses in full.

Medigap Plan L

Medicare Supplement Plan L is one of the supplemental plans that are cost-sharing which means that it covers only one part of your medical costs, so you will be responsible for the remaining costs. Plan L covers 75% of the gaps in Original Medicare after you pay out of pocket for a portion of the costs, including the Part A and B deductibles, and the Part A hospice care coinsurance. The out-of-pocket limit for Plan L is 3,470$ in 2023., after which the plan will cover 100% of the remaining covered costs for the rest of the calendar year.

 

Some of the specific covered costs that Plan L covers include:

  • Part A hospital coinsurance and up to 365 additional days of coverage after Original Medicare benefits are used up
  • Part A hospice care coinsurance or copayment
  • Part B coinsurance or copayment
  • The first three pints of blood used in a medical procedure
  • Skilled nursing facility care coinsurance
  • Foreign travel emergency coverage

 

A with every plan, it’s worth noting that Medigap plans are standardized by the federal government, meaning that Plan L offered by one company must offer the same coverage as Plan L offered by another company. However, the premium can vary between different insurance companies, so it’s best to shop around and compare prices.

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Medigap Plan M

Medicare Supplement Plan M is another cost-sharing plan. Out of  three cost-sharing plans, Medigap Plan M is considered the most extensive one. Plan M covers 50% of the gaps in Original Medicare, including the Part A and B deductibles, and the Part A hospice care coinsurance. However, it doesn’t cover the Part B excess charges.

 

Some of the specific covered costs that Plan M covers include:

  • Part A hospital coinsurance and up to 365 additional days of coverage after Original Medicare benefits are used up
  • Part A hospice care coinsurance or copayment
  • Part B coinsurance or copayment
  • The first three pints of blood used in a medical procedure
  • Skilled nursing facility care coinsurance
  • Foreign travel emergency coverage

 

Medigap Plan M does not cover:

  • The Part B annual deductible
  • Part B excess charges (except for certain states)
  • Long-term care,
  • Vision, hearing or dental care
  • Private-duty nursing
  • Prescription drugs
  • Any other expenses not covered by Original Medicare

Medicare Plan N

Medigap Plan N covers a significant portion of the gaps in Original Medicare, including the Part A and B deductibles, and the Part A hospice care coinsurance. However, it doesn’t cover the Part B excess charges and you will have to pay a small copayment for office visit and emergency room visits.

Some of the specific covered costs that Plan N covers include:

  • Part A hospital coinsurance and up to 365 additional days of coverage after Original Medicare benefits are used up
  • Part A hospice care coinsurance or copayment
  • Part B coinsurance or copayment, except for a small copayment for office visits and emergency room visit
  • The first three pints of blood used in a medical procedure
  • Skilled nursing facility care coinsurance
  • Foreign travel emergency coverage

 

Medigap Plan N does not cover

  • The Part B annual deductible
  • Part B excess charges (except for certain states)
  • Long-term care
  • Vision, hearing or dental care
  • Private-duty nursing
  • Prescription drugs
  • Any other expenses not covered by Original Medicare

 

Typically, Medigap Plan N typically has a lower premium than other Medigap plans, but, as we already mentioned, it will require you to pay a small copayment for office visits and emergency room visits. 

Enroll in a Medicare Supplement Plan

The best time to enroll in a Medigap (Medicare Supplement) plan is during the Medigap Open Enrollment Period, which begins the first month that you are both 65 or older and enrolled in Medicare Part B. This period lasts for six months and during this time, insurance companies cannot deny you coverage or charge you more due to pre-existing conditions. It is generally recommended to enroll during this period to ensure guaranteed acceptance and to secure the best rates.

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Medigap Plan Costs

The cost of a Medigap (Medicare Supplement) plan can vary depending on a number of factors, including the plan you choose, where you live, and the insurance company you buy from. In general, Medigap plans can be more expensive than Medicare Advantage plans, but they offer more flexibility and may provide more comprehensive coverage.

The monthly premium for a Medigap plan can range from around $50 to $500 or more. Some Medigap plans also require an annual or one-time enrollment fee. Additionally, insurance companies are allowed to factor in age, location, and gender in determining the cost of the plan.

It is important to note that Medigap plans do not cover prescription drugs, so if you require coverage for your medications, you may need to purchase a separate prescription drug plan (Part D)

It is recommended to shop around and compare different Medigap plans and prices to find one that fits your budget and coverage needs.