If you are one of the 64 million people in the United States with Medicare coverage, or will soon be eligible, you may have heard about Medicare Supplement plans, also known as Medigap plans. Medicare Supplement, or Medigap, policies cover co-payments, coinsurance, deductibles, and some extra benefits that your Original Medicare Part A and B benefits do not provide.
Medicare Benefits Solutions
Jul 7, 2020
Private insurance companies sell these insurance policies to supplement your Original Medicare coverage, and there are several plans to choose from. Each plan offers different benefits, but they are all designed to protect Medicare beneficiaries from catastrophic medical spending. They are regulated by the federal government, but costs can vary from plan to plan.
Which Medicare Supplement plan is the best?
In 2020, there are ten Medicare Supplement policies in total, but only eight of these policies are available for new enrollees. Starting on January 1, 2020, Medicare Supplement plans were no longer allowed to pay the monthly deductible for Medicare Part B. For this reason, new enrollees can no longer purchase plans C and F. But, if you already had one of these plans (C or F) before January 1, 2020, you can keep your plan.
When choosing the right Medigap plan, you should choose one that fills the gaps in your healthcare coverage in areas where you expect to have your highest health care expenses. The plans with more benefits will have higher premiums, so choosing the right plan for you means balancing the benefits offered with the affordability of premiums.
To get an idea of which plan would work best for your healthcare and financial needs, here is a look at what benefits they offer:
• All ten Medigap policies (A, B, C, D, F, G, K, L, M, and N) include 100 percent of Part A coinsurance and hospital costs for up to 365 additional days after Medicare benefits end.
• Part B coinsurance or copayments are covered 100 percent by Plan A, B, C, D, F, G, M, and N. Plan K covers 50 percent, and Plan L covers 70 percent of these charges.
• The first three pints of blood are covered 100 percent by Plan A, B, C, D, F, G, M, and N. Plan K covers 50 percent, and Plan L covers 75 percent of the cost.
• Part A hospice care coinsurance or copayment is covered 100 percent in Plan A, B, C, D, F, G, M, and N. Plan K covers 50 percent, and plan L covers 75 percent of these charges.
• Skilled nursing facility care is covered 100 percent by Plan C, D, F, G, M, and N. Plan K covers 50 percent, and Plan L pays 75 percent of the costs.
• Part A deductible is covered in full by Plan B, C, D, F, G, and N. Plan K and Plan M cover 50 percent, and Plan L covers 75 percent.
• Medicare Part B deductible is no longer available to new enrollees but is covered 100 percent in Plans C and F for those who were enrolled before January 1, 2020.
• Part B excess charge is covered 100 percent by Plans F and C.
• Foreign travel emergency care (up to the plan’s limit) is covered for 80 percent of the cost by Plan C, D, F, G, M, and N.
For new Medicare enrollees in 2020, Plan G offers the most comprehensive coverage. It offers the most benefits, but it also has the highest monthly premium of around $470.00 on average. On the other hand, the least expensive option is Plan K. Plan K has a current monthly premium between $62.00 and $135.00, but it might not fill all your healthcare gaps. Review your potential healthcare costs and decide if paying a higher premium may be a wiser option for you.
How do Medicare Supplement insurance plans work?
When you turn 65 years old and you’re enrolled in Part B (medical insurance), you can purchase a Medicare Supplement plan from a private insurance company in your state. Please note that if you have a Medicare Advantage (Part C) plan, you cannot purchase a Medicare Supplement policy.
How Does Medigap work with Original Medicare? When you have both Original Medicare and a Medicare Supplement plan, Original Medicare coverage pays its share of the costs first and then Medigap pays the remaining amount. You will pay a monthly premium to your private insurance provider for the Medigap plan, but you will also be responsible for paying your Medicare Part B premium separately.
When can you enroll in a Medicare Supplement plan?
When you turn 65 and are enrolled in Part B, you’ll have a 6-month Medigap open enrollment period. During this time, you can buy any Medigap plan sold in your state, regardless of any pre-existing health conditions. If you decide to purchase a plan after your open enrollment period ends, you risk being refused coverage or paying a higher premium for it. Once you have purchased a Medigap plan, the provider cannot cancel or refuse to renew your coverage even if you have health problems, as long as you pay your premium.
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