Medicare Supplement (Medigap)
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.). I 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, Medicare Supplement plans are "guaranteed issue." You will be approved for coverage, as your health history is not considered.
-All Medicare Supplement 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. That is because Federal law mandates that any insurance company offering Medicare Supplement plans adopt Medicare as their “network.” The insurer cannot insist on 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.
The only reason insurers can cancel your coverage is if you do not make the premium cost payments.
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 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 with an optometrist, 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, and what medical costs you might be responsible for, to help you choose the Medicare supplemental 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
Plan G pays all of the medical costs Medicare Parts A and B leave for you to pay with only one exception, the $240 Medicare Part B deductible. You would incur the Part B Medicare deductible as an out of pocket expense at a doctor’s office visit.
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 $240. For the entire calendar year. (prescription costs are not covered here, but by Part D Rx plans)
Plan G is usually the most cost-efficient plan
Insurers set their monthly costs based on a number of factors, such as benefits, claims history, and administrative costs.
But they also want to be competitive. Insurers, really wanting to sell you a plan, try to be as competitively-priced as possible. 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 less than plan designs that offer fewer benefits!
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.
A Few of the Medicare Supplement Insurance Providers We Work With
Free Info 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 on Privacy: Keeping the information you share private is of the utmost importance to us. We do not share any information with third parties. A minimum of information (no contact info!) is shared with an insurance company to put together a detailed free quote and illustration for you.