What is “Medigap”? Do I need it?
Picture this: You're standing at a crossroads, facing the maze of Medicare choices. Medicare Supplement plans are like the trusted sidekicks, filling in the gaps left by Original Medicare. In this article, we're your guide, your compass. Get ready to explore the world of Medicare Supplements, where you're in control and well-equipped to conquer your healthcare journey!
What is a Medicare Supplement?
A Medicare Supplement is additional coverage you can purchase to ‘fill the gaps’ (also known as Medigap) in Original Medicare cost sharing. These plans are sold by private insurance companies, and are secondary to Original Medicare. Generally, Medicare Parts A and B cover about 80% of the cost (after deductibles are met).
Medicare Supplements are named with a letter, such as ‘Plan G’, ‘Plan N’ or ‘Plan F’. Medicare Supplements are standardized; the only difference between plans of the same letter is the price set by each company offering the plan. A Medicare Supplement Plan is not the same as a Medicare Advantage Plan and you cannot have both plans at the same time.
Why would I need a Medicare Supplement?
Many people are concerned with the costs that Medicare doesn’t cover. That is why many people purchase a Medicare supplement plan, also known as Medigap, to fill in the “gaps” in Original Medicare coverage. Medigap plans, depending on the coverage level you select, can cover some or all of your out-of-pocket costs. Medigap plans have NO NETWORK and no referrals.
It is important to note, that when you have a Medicare Supplement paired with Original Medicare, Original Medicare is the primary. Because of this members can see any doctor that accepts Medicare assignment. Sometimes a member will call a doctor’s office and ask if they take, for example, United Healthcare Medicare plans when the member has a Supplement plan issued by United Healthcare. This can cause confusion for the office as they will likely presume the client is referring to a Medicare Advantage plan, that has a network of providers.
Medicare Supplement plans only pay after Medicare has first paid their share of the costs. If Medicare approves a claim and pays their part, the remainder of the bill is sent to your Medicare Supplement insurance company.
12 Standardized Medicare Supplement Plans
The above images are sourced directly from Medicare.gov
Let’s Discuss the most popular of these 12 plans.
Plan F, Plan G, and Plan N are the most popular Medicare Supplement plans, even though Plan F is not available to everyone. Plan F is only available to the beneficiaries who turned 65 on or before January 1, 2020. Plan F was considered the best Medicare plan, because it covers all Medicare approved services 100%; it is also typically the highest premium. The difference in coverage between the Plan G and Plan F, is that Plan F covers the Part B deductible. However, the money you save by having a lower premium with Plan G can often be more than the $226 deductible difference between the two plans. So, for many people, choosing Plan G might be more cost-effective overall despite the deductible.
What does a Medicare Supplement cost?
Medigap can be expensive but compared to what you may have been paying before you were 65 it may seem like a bargain. The average cost of Medicare Supplement plans can vary by many factors. Age, location, gender, tobacco use, household discount, plan choice and more is taken into consideration when our brokers are looking for the most suitable plan. Rates will vary based on zipcode, but the most substantial difference is between states. For example, a Plan G for a male age 67 will have a much higher premium in Florida than a Plan G for a male age 67 in North Carolina.
When considering a Medicare Supplement the plan premium is not the only cost to consider. Supplement plans do not usually cover Part D prescription drug benefits, so you will need a stand alone Prescription Drug Plan as well to avoid the Part D Late enrollment Penalty. Supplements do not cover routine dental, vision, or hearing, long term or custodial care either.
Pros and Cons of Medicare Supplement Plans
Is a Medicare Supplement plan right for you? Are there any alternative options?
Compare Medicare Supplement vs Medicare Advantage
After reading this post you may be wondering, ‘is Medigap worth it?’ We believe, yes. But is it the right choice for your family? Speak with our team today to compare Supplement plans and get a quote quicker than you can say “Medigap”!
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