Medicare Supplement (Medigap)
Medicare Supplement (Medigap) Plans
Once enrolled in Medicare you will want to choose supplemental insurance, either (Avenue 1) Medicare Supplement + Part D Rx Plan, or (Avenue 2) Medicare Advantage. This page explains the details of Medicare Supplement (Medigap) plans.
Medicare Supplement (Medigap) plans insurance policies designed by Medicare and offered by private insurance companies that are designed to pay part or all of the "gaps" in Medicare coverage (i.e., what Medicare Parts A and B do not pay at the hospital, doctor’s office, urgent care, emergency room, etc.).
We like to say that Medicare Supplement plans "dovetail" with Medicare, filling in right where Medicare leaves off, to pay the deductibles, daily amounts, and coinsurance you would pay if you did not choose any supplemental insurance.
There are certain features all Medicare Supplement plans offer:
-Medicare Supplement plans are “standardized” and easy to compare
Medicare, not insurance companies, designed Medicare Supplement insurance plans, and what benefits they offer. Insurers must offer the plan just as mandated. No exceptions.
You can make your choice based on easier differentiating factors, like monthly cost, the insurer’s financial strength, and their reputation for customer service.
-Medicare Supplement plans are easy to begin
Medicare Supplement plans are easy to enroll in. There are no physical exams or medical records to send in.
When you enroll in coverage on or near your 65th birthday, or enroll after age 65 because your employer health insurance is ending, Medigap plans are "guaranteed issue." You will be approved for coverage, as your health history is not considered.
-All Medigap plans use the same provider network…Medicare
If a doctor, hospital, or provider accepts Medicare then you automatically know they accept your Medicare Supplement insurance plan, no matter which insurance company you chose.
This is because Federal law mandates that any insurance company offering Medicare Supplement plans adopt Medicare as their “network.”
-Medicare Supplement plans are easy to keep
Medicare Supplement plans are easy to keep. Insurance companies cannot cancel the Medigap coverage because your health history has changed, or that you have incurred too many claims.
Not making the premium cost payments are the only reason for cancellation.
And if you move permanently to a new state, the Medigap plan moves with you.
-You can use Medigap coverage in all 50 states, not just your state
There are Medicare providers in all 50 states, and you can visit any type of Medicare provider. Anywhere, anytime.
So you never need to feel like you can only visit doctors in your town. Your Medicare and Medicare Supplement covers you well when you are traveling. And covers you if you want to see a specific doctor elsewhere in the U.S.
-Medicare Supplement plans can offer discounts
Medicare Supplement plans cannot offer true built in insurance benefits such as dental and vision (as Medigap plans are standardized).
But many offer discount programs that save you money on services that Medicare does not cover; such as eye exams, eyeglasses or contacts, hearing tests and hearing aids, gym memberships, etc.
Medicare Supplement Plan Designs
This chart is a helpful visual in helping you see how the plans are standardized, regardless of the insurance company you choose. It also shows how the medical expenses Medicare Parts A and B leave for you to pay are covered by the differing plan designs.
To be honest, this chart is kind of boring and confusing to follow. Chip can walk you through how the benefits work in a more conversational way, so you can understand what is covered by Medicare Parts A and B, then by the Medicare Supplement, and what medical costs you might be responsible for. This understanding will help you choose the Medigap plan design that fits you best.
When Reviewing Medigap Plan Designs, Note Plan G
We recommend Plan G as the best Medicare Supplement plan choice a majority of the time. Here is why:
Plan G is the most benefit-rich Medigap plan choice
Plan G pays all of the medical costs Medicare Parts A and B leave for you to pay with only one exception, the $257 Medicare Part B deductible. You would incur the Part B Medicare deductible as an out of pocket expense at a first doctor’s office visit or two each year.
With Plan G you know that your out of pocket maximum of expenses you could pay when visiting hospitals, doctor’s offices, surgical centers, urgent care & emergency rooms is $257. For the entire calendar year!
Plan G is usually the most cost-efficient Medigap plan
Insurers set their monthly premium costs based on a number of factors, such as benefits, claims history, and admin. costs.
But they also want to be competitive! Over time, the most pricing pressure is placed on the most popular plans. (currently Plan G). So Plan G rates have dipped, while other plan designs have not received pricing pressure.
Reviewing insurers’ current rates, the monthly cost of Plan G is many times the same or even less than plan designs that offer fewer benefits!
Plan G covers Part B excess charges
Plan G is the only Medicare Supplement plan design that covers “Part B Excess Charges,” if any.
Though rare, some doctors do not accept “Medicare Assignment” (the set amount Medicare pays per service), and bills you for the difference between Medicare Assignment and what they want to charge, up to 15% above the Medicare approved amount.
Plan G will pay for these Part B excess charges, leaving none of those costs for you to pay.
Note: You can shop for a new Medigap plan any time in the year
Many people mistakenly believe you can only shop for a new Medicare Supplement (Medigap) plan during the Annual Enrollment Period (AEP) October 15th - December 7th.
The truth is you can shop for, and enroll in a new Medicare Supplement (Medigap) plan any time in the year, for whatever reason! When doing so, in most instances, the insurer may ask you some health questions. This scares many from applying, but should not. The questions are specific, and most could not answer “Yes” to them. We can share the questions with you before applying.
We work with all Medicare Supplement (Medigap) Insurers, including…
Free Information Packet and Quotes
Complete the form below and we will send you clear, concise information about Medicare + supplemental insurance, along with quotes to consider from insurance companies. We will compare the plans’ benefits and costs, and recommend what looks best based on your details and preferences.
Note: Privacy is something we take seriously. The minimum of information is shared with an insurance company to put together a detailed free quote and illustration for you.