%20(3168%20%C3%97%201440%20px).png)
Medicare Supplement Plans (Medigap)
Nearly ten million Medicare beneficiaries are covered by Medicare Supplement plans. These policies, also known as Medigap plans, help pay for your share of Medicare costs, such as deductibles and coinsurance. Medicare supplement insurance plans are available in all 50 states and are very popular among people who want to pay little or no copays for healthcare services.
​
Many people who are new to Medicare are surprised to learn that Medicare only covers 80% of Part B expenses. If you develop a serious illness, the remaining 20% can be financially devastating. You can get a Medicare Supplement that will cover some or all of that 20%, as well as other benefits. Supplemental insurance for Medicare beneficiaries provides peace of mind by removing the cost-sharing obligation. Additionally, you are guaranteed the right to purchase a Medicare Supplement plan during your one-time open enrollment period. It doesn’t matter if you’re healthy or not when you buy a plan during this six-month period.
Supplements to Medicare were created shortly after Medicare was signed into law. Because you must pay for certain things, such as 20% of outpatient expenses, supplemental policies were created to cover those costs. This alleviates people’s concerns about how much each medical visit will cost them.
​
The following are some of the primary benefits of a traditional Medicare Supplement policy:
​
-
You have the freedom to select your own doctors and hospitals.
-
There is no need for a referral to see a specialist.
-
Out-of-pocket costs for Medicare-covered services that are predictable (and zero out-of-pocket with Plan F)
-
You can use it anywhere in the United States because it has nationwide coverage.
-
Guaranteed renewability – due to a health condition, the insurance company will never drop you or change your coverage.
Supplemental insurance for Medicare recipients is the most reliable back-end coverage available. Depending on which Medigap plan you choose, you’ll know exactly what’s covered for each inpatient or outpatient procedure. Some additional notes to make about Medicare Supplement insurance include:
​
-
To purchase a Medigap policy, you must have both Part A and Part B.
-
Medicare Supplement plans only cover one individual. Your spouse needs to have his or her own policy.
-
You have the option of discontinuing your supplement at any time. Medicare Supplement plans do not have an annual election period.
-
Drug plans are voted on during the Annual Election Period in the fall. It has nothing to do with Medicare supplements.
-
If two or more people enroll in Medicare supplemental plans from the same company, many carriers offer household discounts.
-
Because the plans don’t include Part D, you’ll need to purchase a separate Part D drug plan.
After Medicare approves and pays its share of your claim, Medicare Supplement plans kick in. They are Medicare gap insurance policies that help to cover the Medicare coverage gaps that you would otherwise have to pay for. Deductibles, coinsurance, and copays are examples of this.
You can use your Medicare Supplement plan at any Medicare-accepting provider in the United States. Medicare Supplements are ideal for people who travel or live in more than one state throughout the year.
You’ll want to purchase a separate Part D drug plan to cover your prescriptions because Medicare Supplements do not cover retail drugs. Routine dental, vision, and hearing services are not covered by a Medicare Supplement.
The Medicare handbook can be daunting to sift through, so we tried to use simpler terms and visuals here. Take a look at our Medigap supplement chart below to see a list of all the Medicare supplemental plans available. This chart can be found in the Medicare booklet Choosing a Medigap Plan which can be found here. It explains how each plan covers different benefits and services.
Click here to download a PDF copy of the 2021 Compare Medicare Supplement Plans Side-by-Side chart.
Each letter in the chart above corresponds to a Medicare Supplement plan, ranging from A to N. Each plan letter comes with its own set of advantages. Regardless of which insurance company you choose, however, each lettered plan must have the same standardized coverage. Please note, our agency only offers Medigap plans F, G, N, and High Deductible Plan G.
Plan F, a supplemental insurance plan, covers ALL of the gaps and leaves you with no out-of-pocket expenses. Others offer a lower monthly premium if you agree to share some of your costs. If you prefer something in the middle, you might want to consider Plans G or N, which require you to pay for a few things in exchange for lower premiums.
Having group health coverage through an employer prompts people to put off enrolling in a supplement. You have the right to purchase certain Medigap policies within the 63 days following the loss of your group coverage if you retire or lose that coverage later. This is referred to as your guaranteed issue rights for Medicare supplements.
Other circumstances, such as losing Medicare Advantage coverage when moving out of state, can also trigger a guaranteed issue window. Guaranteed issue rules differ from state to state, so feel free to contact us for more information on these laws in Nebraska. Also, keep any notices from your previous carrier that show proof of your creditable coverage for guaranteed issue as well as to avoid the Part D late enrollment penalty.
You can still apply for a Medicare supplement if your open enrollment or guaranteed issue window has passed, but you will have to answer some health questions on your application. Some people are perplexed by this because they believe they can change their supplements without underwriting during the Annual Drug Election Period in the fall. Unfortunately, only drug plans and Medicare Advantage plans are eligible for the autumn election period. In most cases, switching Medigap carriers will necessitate underwriting.
-
When is the open enrollment period for Medicare supplemental plans?
-
When people activate Medicare Part B for the first time, they have six months to enroll in any Medicare Supplement without having to answer any health questions. The insurance company will approve your application without a waiting period for pre-existing conditions. The Medicare Supplement Open Enrollment Period is what we call it—a one-time opportunity. Keep in mind that the Annual Election Period (AEP), which takes place every fall, is NOT a time when you can apply for a Medicare supplemental insurance plan with no health questions asked. The AEP has no bearing on Medigap plans. Instead, it’s a chance to switch your Part D drug plan.
-
-
Can I change Medicare supplements anytime?
-
You can change your Medicare Supplement at any time, but you may be required to answer health questions if you are past the Open Enrollment period. Your health and medication history will be reviewed by the Medicare supplement insurance company. They have the option to accept or reject you.
-
-
What does “guaranteed issue” mean when it comes to Medicare supplemental insurance?
-
An insurance company must accept you for coverage in certain circumstances without asking any health questions. If you are on Medicaid and lose your eligibility, you have a limited time to apply for Medigap without having to answer any health questions. Another example would be someone who is transitioning from employer-sponsored health insurance to Medicare. Under guaranteed issue rules, they will have a limited time to apply for certain Medigap plans.
-
-
Do I really need supplemental Medicare insurance?
-
​Medicare Supplements are optional. You would be responsible for expensive hospital deductibles and copays, as well as 20% of the cost of ALL outpatient services if you didn’t have any supplemental insurance. Surgical procedures and chemotherapy, for example, would be financially crippling without some form of supplemental coverage.
-
Next Steps
People frequently ask which Medicare Supplement plan is the best when in reality it depends on a variety of personal factors. What works for a friend or neighbor might not work for you. Our Medicare-certified agents are happy to help talk through your personal factors and Medicare Advantage plans that may work for you. If you’re interested in discussing the Medicare Supplement options and what will work best for you, contact us or schedule an appointment using our online booking system.