A Big Picture View of Medigap Plans
In 2023, there are 12 available Medicare supplement plans, each of which must be compared side-by-side to determine their differences.
It is critical to avoid confusing Medigap “plans” with Medicare “parts.” Parts A, B, C, and D constitute Medicare. Parts A and B, also known as Original Medicare, provide inpatient and outpatient services, while Part C, also known as Medicare Advantage, and Part D offer prescription drug coverage. Medigap plans supplement coverage for Medicare Parts A and B.
Medigap policies do not cover everything. To be specific, they typically do not cover long-term care, dental or vision check-ups, or hearing aids or eyeglasses. Nonetheless, a Medigap policy can assist with many remaining healthcare costs left behind by Original Medicare.
What are Medigap plans?
Medicare supplement plans, also known as Medigap plans, serve as secondary payers to Original Medicare. This is because Parts A and B do not cover 100% of healthcare expenses, leaving beneficiaries with remaining costs. Medicare supplements can help pay for these costs, as long as the healthcare provider accepts Medicare assignment and the supplement plan.
These plans are only sold to individuals, meaning that spouses must each carry their own policy, although some insurance companies offer household discounts if both individuals are on the same plan with the same carrier.
The benefits offered by a Medicare supplement plan vary depending on the plan, but they may include payment for coinsurance costs, inpatient and outpatient deductibles, extra days for hospital stays, hospice care, blood transfusions, and more.
Medigap Eligibility & Enrollment
To be eligible for a Medigap plan, the primary requirement is to be enrolled in Original Medicare (Part A and Part B). Medicare beneficiaries who are 65 years old, receiving social security disability benefits for 24 months, or diagnosed with ALS or ESRD are all eligible to enroll in Medicare.
It’s crucial to enroll in a Medigap plan during your Open Enrollment period, which begins on your Part B effective date. This guarantees your issue rights to a Medigap policy. While it’s still possible to apply for a policy outside this enrollment period, you may not be granted guaranteed issue rights, which could lead to denial of enrollment in a plan.
The 12 Medigap Plans
The 12 Medigap plans are identified by letters A through N, and each offers unique benefits. Regardless of the plan chosen, there is coverage for out-of-pocket expenses that remain after Original Medicare benefits have been utilized. This coverage may include deductibles, copays, and coinsurance costs.
Every insurance carrier that sells Medigap plans must offer Medigap Plan A. This is the most basic Medigap plan and offers the least amount of coverage.
Plan B offers a little more coverage than Plan A. With Plan B, the Medicare Part A inpatient deductible is covered.
Plan C covers all benefits except the Part B excess charges.
Plan D offers benefits for everything under Original Medicare, but does not pay for the Part B deductible or Part B excess charges.
Plan F is the most comprehensive coverage. It is considered first-dollar coverage because outside of the monthly premium, there are no out-of-pocket expenses. However, this plan is only available to those who turned 65 prior to January 1, 2020.
This plan is the same as Plan F, but offers a lower premium in exchange for a higher deductible.
For those who are ineligible for Plan F, Plan G is the next best option. It is currently one of the most popular Medigap plans. It offers coverage for everything except the Part B deductible.
This plan is the same as Plan G, but offers a lower monthly premium in exchange for a higher deductible.
Plan K only covers 50% of some of the benefits that other plans cover 100% of.
Plan L only covers 75% of some of the benefits that other plans cover 100% of.
Plan M only covers 50% of the Part A inpatient deductible and it does not cover the Part B deductible or the Part B excess charges.
Plan N is another of the more popular Medigap plans. It has small copays, but covers everything else except the Part B deductible and Part B excess charges.
How to Compare Medigap Plans
While there is plenty of information available online about each Medicare plan, getting an accurate quote can be tricky without the assistance of a licensed agent. Rather than reaching out to each insurance carrier individually, we can help you compare premiums from a variety of carriers to find the plan with the best rate for you. To provide accurate quotes, we’ll need some information from you about your health history, but our services come at no additional cost to you.
Get More Information About Medicare Costs
The cost of Medicare typically undergoes annual changes, and it is essential for beneficiaries to understand how these costs are calculated in order to ensure they are getting the best value. Therefore, beneficiaries should have their coverage evaluated each year. Our team of licensed agents can conduct a review of your plans to ensure you are receiving the most comprehensive coverage for the most reasonable price.