Medicare Supplements
Medicare Supplement plans, also known as Medigap plans, are plans that fill in the gaps to cover costs that are not covered by Original Medicare (Parts A and B). Original Medicare covers many costs so you do not have to, but it does not cover everything. This is why some Medicare beneficiaries choose to add on a Medigap plan as they can help pay remaining costs, such as:
- Coinsurance
- Deductibles
- Copayments
How Do I Enroll in Medigap?
Before you can enroll in a Medigap plan, you must be enrolled in Original Medicare and are 65 years old. You will then have six months to enroll in a Medigap plan without the worry of going through medical underwriting, being charged more in monthly premiums, or being denied coverage. This is because during the six-month period known as the Medigap Open Enrollment Period, you have guaranteed issue rights (also known as Medigap Protections) that make it to where insurance companies cannot deny you coverage or charge you more due to your health.
It is still possible for you to enroll in Medigap after the Medigap Open Enrollment Period has ended, but do note that your chances of getting the Medigap plan you want are lowered.
You also will not be able to have a Medigap plan while enrolled in a Medicare Advantage (Part C) plan. This is because Medicare Supplements are only meant to supplement your Original Medicare coverage, while Medicare Advantage is another option you can choose besides Medigap that is considered an alternative to Original Medicare.
How Do Medigap Plans Work?
If you are enrolled in Original Medicare and choose to buy a Medigap plan, here’s how both sets of coverage will work:
- Original Medicare will pay first for its share of your covered healthcare expenses
- Once its share is paid, your Medigap plan will pay its share
While Medigap plans will cover what they can, keep in mind that just like Original Medicare, they do not cover everything. These plans will not cover long-term care, dental care, vision care, hearing care, or private-duty nursing.
What Do Medigap Plans Cover?
Knowing what each Medigap plan covers is an essential part in knowing which plan will fit your coverage needs the best. Here is a quick overview of each Medigap plan and what they cover so you can have a better understanding:
Medigap Plan A:
Plan A is the most basic Medicare Supplement plan available. While it does provide basic coverage, it can still be seen as a great option for some Medicare beneficiaries as it does cover 100% of:
- Part A coinsurance and hospital costs
- Part A hospice care coinsurance and copay
- Part B coinsurance and hospital costs
- First three pints of blood for a transfusion
Medigap Plan B:
Plan B is another basic coverage plan that covers the same things as Plan A:
- Part A coinsurance and hospital costs
- Part A hospice care coinsurance and copay
- Part B coinsurance and hospital costs
- First three pints of blood for a transfusion
However, it also covers the Part A deductible.
Medigap Plan C:
Plan C is one of the more comprehensive plans available. However, these plans are only available to those who became eligible for Medicare before January 1, 2020. Plan C will cover 100% of:
- Part A coinsurance and hospital costs
- Part A hospice care coinsurance and copay
- Part A deductible
- Part B coinsurance and hospital costs
- Part B deductible
- First three pints of blood for a transfusion
- Skilled nursing facility care coinsurance
Plan C will also cover 80% of foreign travel emergency care.
Medigap Plan D:
Plan D does not provide the most comprehensive coverage, but it also does not provide the most basic coverage. Plan D will cover 100% of:
- Part A coinsurance and hospital costs
- Part A hospice care coinsurance and copay
- Part A deductible
- Part B coinsurance and hospital costs
- First three pints of blood for a transfusion
- Skilled nursing facility care coinsurance
Plan D will also cover 80% of foreign travel emergency care.
Medigap Plan F:
Plan F is the most comprehensive plan available. However, similar to Plan C, these plans are only available to those who became eligible for Medicare before January 1, 2020. Plan F will cover 100% of:
- Part A coinsurance and hospital costs
- Part A hospice care coinsurance and copay
- Part A deductible
- Part B coinsurance and hospital costs
- Part B deductible
- Part B excess charges
- First three pints of blood for a transfusion
- Skilled nursing facility care coinsurance
Plan F will also cover 80% of foreign travel emergency care.
Medigap Plan G:
If you are not eligible to enroll in Plans C or F, Plan G is your next best option for comprehensive coverage. Plan G will cover 100% of:
- Part A coinsurance and hospital costs
- Part A hospice care coinsurance and copay
- Part A deductible
- Part B coinsurance and hospital costs
- Part B excess charges
- First three pints of blood for a transfusion
- Skilled nursing facility care coinsurance
Plan G will also cover 80% of foreign travel emergency care.
Medigap Plan K:
Plan K is different compared to the other Medigap plans. While the other plans will either provide 100% coverage for specific costs or have no coverage at all, Plan K will provide cost-sharing.
Plan K will provide 100% coverage for Part A coinsurance and hospital costs, but it will only cover 50% of:
- Part A hospice care coinsurance and copay
- Part A deductible
- Part B coinsurance and hospital costs
- First three pints of blood for a transfusion
- Skilled nursing facility care coinsurance
Plan K also has an out-of-pocket limit which is $6,620 in 2022.
Medigap Plan L:
Similar to Plan K, Plan L also has cost-sharing. Plan L will provide 100% coverage for Part A coinsurance and hospital costs, but it will only cover 75% of:
- Part A hospice care coinsurance and copay
- Part A deductible
- Part B coinsurance and hospital costs
- First three pints of blood for a transfusion
- Skilled nursing facility care coinsurance
Plan L also has an out-of-pocket limit which is $3,310 in 2022.
Medigap Plan M:
Plan M will cover 100% of:
- Part A coinsurance and hospital costs
- Part A hospice care coinsurance and copay
- Part B coinsurance and hospital costs
- First three pints of blood for a transfusion
- Skilled nursing facility care coinsurance
Plan M will also cover 50% of the Part A deductible and 80% of foreign travel emergency care.
Medigap Plan N:
Plan N provides the same coverage as Medigap Plan D. Plan N will cover 100% of:
- Part A coinsurance and hospital costs
- Part A hospice care coinsurance and copay
- Part A deductible
- Part B coinsurance and hospital costs
- First three pints of blood for a transfusion
- Skilled nursing facility care coinsurance
Plan N will also cover 80% of foreign travel emergency care.
With Plan N, you may also have to pay a $20 copayment for some doctor office visits and up to a $50 copayment for ER visits.
How Are Medigap Premiums Determined?
The monthly premiums for Medigap plans are determined by the insurance company. Before jumping right in and buying a Medigap plan, though, it is important that you ask how the insurance company prices its policies.
Medigap plans can be priced in three different ways:
- Community-Rated: Also referred to as No Age-Rated, this pricing system is not based on your age. This means the same monthly premium will typically be charged to everyone who has the plan, regardless of age, and will also not increase as you age.
- Issue-Age-Rated: Also referred to as Entry Age-Rated, this pricing system bases your monthly premiums on the age when you buy the Medigap plan. Premiums will be lower for those who purchase a Medigap plan at a younger age. Your premiums also won’t increase as you age.
- Attained-Age-Rated: With this pricing system, your monthly premiums will increase as you age. However the younger you are when you get the plan, the lower your premiums will start out.
Regardless of how an insurance company prices the plan, the monthly premiums are always subject to increase due to factors besides age, such as inflation.
Learn More About Medigap With Affordacare Insurance
At Affordacare Insurance, our goal is to find you the coverage that works best for you. That’s why if you are interested in learning more about your Medicare Supplement options, give us a call today. We are here to help you compare all of your coverage options and compare quotes from many different insurance companies so you can have coverage that fits within your budget.
