Supplements/Medigap

Medicare Supplement plans cover over 10 million Medicare beneficiaries. Also referred to as Medigap plans, these policies help pay for your share of Medicare expenses, such as your deductibles and co-insurance. Medicare Supplement insurance plans are available for purchase in all 50 states and are popular with individuals who want little to no copays when they access healthcare services, and thus, no billing surprises.

Many people new to Medicare are surprised to find Medicare covers only a portion of their Part A (Inpatient Hospital) expenses and 80% of their Part B (Medical) expenses. The expenses you are responsible for can be devastating financially if a serious illness arises. Medicare Supplements help to pay Part A and Part B expenses and offer you peace of mind by eliminating that cost-sharing responsibility.

Most importantly, during your one-time Supplement Open Enrollment Period, you are guaranteed the right to purchase a Medicare Supplement plan regardless of your health status or medical condition.

Supplement Plan advantages include:

Freedom to see any doctor or provider in the U.S. that accepts Medicare; important if you travel throughout the U.S. or have a second home elsewhere.
No referrals required to see a specialist.
Predictable out-of-pocket expenses for Medicare-covered services and zero out-of-pocket with Plan F.
Guaranteed renewability – the insurance company can never drop you or change your coverage due to a health condition.
No claims paperwork – Medicare Supplement companies have crossover filing with Medicare. When your provider files a claim with Medicare, that claim is automatically filed with your Supplement company.

Medicare Supplement plans offer you peace of mind. You will know exactly what’s covered for every inpatient or outpatient procedure based on which Medigap plan you choose.

Some other things to know:

You must have Part A and Part B to buy a Medigap policy.
Medicare Supplement plans cover only one person. Your spouse must have his or her own individual policy.
You can drop your Supplement at any time. There is no annual election period for Medicare Supplement plans. However, if you want to instead enroll in a Medicare Advantage Plan, be careful to move from a Supplement to an Advantage Plan during a valid enrollment period such as during the MAPD Annual Enrollment Period in the fall of each year, with a January 1 effective date.
You can change your Supplement plan at any time, but once you are past your one-time Supplement Open Enrollment Period, the carrier can ask you health-related questions and potentially turn down your application or charge a higher monthly premium.
The annual election period in the fall is for drug plans and Medicare Advantage plans. It does not apply to Medicare Supplements in any way.
Many carriers offer household discounts if two or more people enroll in Medicare Supplement plans from the same company.
Supplement plans do not include Part D for prescription drugs so you will need to enroll with a separate standalone Part D drug plan.
For Medicare-approved benefits, Medicare pays first. Then the Supplement plan company pays its share. This is usually the remainder of your bill; however, it depends on which policy you choose from the standard offered plans.

Supplement Plans

Every Medicare Supplement must follow the guidelines created by Medicare when it standardized all plans in 1990. Each standardized plan is identified by a letter. There is Plan A, Plan B, Plan C, Plan D, Plan F, Plan G, Plan K, Plan L, Plan M and Plan N. Each one of these lettered policies provides exactly the same set of benefits from company to company. This means that the monthly premium is the main difference between Supplements with the same letter.

You can shop multiple insurance carriers for the best rate, and our agents can help you with that. The plans that we get the most quote requests for are Supplement Plans F, G, and N.

Plan F pays 100% of the Medicare-approved costs that Original Medicare would normally bill to you. This means that when you have Medicare Supplement Plan F, you will not pay any deductibles nor any copays. Plan F will pay ALL your share of Medicare-approved costs.

Plan F is no longer available to individuals new to Medicare on or after January 1, 2020.

Plan G has been gaining popularity in recent years. Plan G functions exactly like Plan F, except you are responsible for the Part B medical deductible which is paid once per year. After the deductible is paid, the plan covers costs just like Plan F. In 2023, the Part B deductible is $226 per year.

Plan N is one of the newer Medigap plans, first offered in 2010. Plan N usually has lower premiums than Plan F or Plan G. However, you will have more cost-sharing along the way. You will have a doctor copay up to $20 each time you see a doctor and an ER copay of up to $50.

Similar to Plan G, you are responsible for the annual Part B medical deductible of $226 for 2023.

You will also pay excess charges if applicable in the state you receive your medical services. Some doctors bill an extra 15% above Medicare’s rate. This is called an Excess Charge. Plan F or Plan G take care of this for you. On Plan N, you pay the excess charge yourself.

What is Not Covered by Medicare Supplement Plans?

Some things that are not covered by Medicare or by Medicare Supplement plans are:

Routine dental, vision and hearing exams
Hearing aids
Eyeglasses or contacts
Retail prescription drugs
Routine foot care
Cosmetic surgery
Long-term care or custodial care

As Medicare Supplement plans do not include retail prescription drug coverage, you will need to enroll in a standalone Part D drug plan for your medications. You should enroll in a Part D plan even if you do not take any prescriptions, as Medicare will assess you a permanent late enrollment penalty if you delay your enrollment. That penalty grows with each month you are not enrolled.

Medicare Supplemental Plans – Open Enrollment

Per Medicare’s Guide to Health Insurance, the best time to buy a Supplement policy is during your one-time Supplement Open Enrollment Period. This window begins on the first day of your birth month, or the month that you enroll in Part B. The enrollment period lasts for six months and is a “use it or lose it” enrollment period.

During your one-time Supplement Open Enrollment, the Medicare Supplement company cannot ask you any medical questions. They cannot turn you down for any health conditions. They cannot refuse you a policy or charge you any additional amount due to health conditions, medications or pre-existing illnesses. You will have your choice of Medicare Supplement plans.

After this window passes, however, future insurance companies that you might apply with can accept or decline you based on health. That is why the handbook states that open enrollment is the best time to enroll.

Please note: The Annual Election Period in the fall is NOT a time when you can change Medigap plans with no health questions. Many people mistakenly believe this. The Annual Election period in the fall pertains to your Part D plan and to Medicare Advantage plans, not your Medigap plan.

Contact one of our advisors to get a personalized analysis of which Medigap insurance carrier offers the best pricing.

We are here to help!

We understand how confusing this may be, and we are here to help. Schedule a counseling session with one of our trusted advisors. During this session, your advisor will explain how Medicare works, what actions you need to take, costs and more.

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