Medicare Supplement
Filling the gaps left by original Medicare
Whether purchasing your first Medicare Supplement plan or switching to a new option, United Medicare Advisors (UMA) is united in your Medicare journey and in helping you get the best value from Medicare Supplement Insurance coverage.
Medicare Supplement: Overview and Medigap Basics
Original Medicare (Part A and Part B) covers most, but not all, of the health care costs you may see. Medicare Supplement Insurance, also called Medigap, helps fill the "gaps" which original Medicare doesn’t cover to help mitigate costs and offer Medicare beneficiaries peace of mind. It’s important you understand this important resource, the benefits it offers, and how you can derive the greatest value from Medigap.
What is Medigap?
Medigap (another name for Medicare Supplement Insurance) covers all or part of some costs left over after Original Medicare pays its share first. Medigap typically covers costs associated with deductibles, copayments, coinsurance, and more. Because plan benefits are standardized and structured the same from company to company, Medigap beneficiaries can see any doctor in the Medicare network, even doctors in other states.
What does Medigap cover?
Costs covered by Medigap include:
- Deductibles for Parts A and B
- Excess costs for Part B
- Coinsurance or copays for Parts A and B
- Blood (first three pints)
- Health care costs during travel abroad
Why Should I Have a Medicare Supplement Plan?
Having a Medicare Supplement plan in addition to Original Medicare helps protect you from unexpected costs so you can get the care you want without worry of financial burden. Because of the guaranteed coverage during your Medigap Open Enrollment Period, it's a great option for those with pre-existing conditions as well. Plus, it allows you to continue receiving the federal Medicare benefits you have been paying for throughout your working years.
Key Advantages of Medicare Supplement Insurance
Guaranteed renewability each year
Do Medicare Supplement plans automatically renew? As long as you pay your premium, your coverage will continue year after year and cannot be canceled (except in specific cases, like providing inaccurate information on your application).
Simple, straightforward plan options
Because Medigap policies are federally standardized, they are fairly straightforward and simple to understand, making it easy to compare Medicare Supplement plan options and select Medigap coverage.
Nationwide network of doctors and specialists
Medicare Supplemental Insurance enrollees can visit any doctor that accepts Medicare coverage. Doctors or hospitals that accept Medicare are required to accept all Medigap plans, regardless of insurance carrier.
More flexibility with treatment options
Some Medicare Advantage plans require you to choose a primary care physician, who has the final say on what providers you can see. Medigap plans allow you the flexibility to select any treatment option you prefer.
What Medicare Supplement Plans cover
Together, Medicare Parts A and B cover about 80 percent of the health care costs that seniors generally face. However, the 20 percent not covered by Medicare Parts A and B can represent a significant amount, which is where Medicare Supplement plans come in. They help extend coverage, mitigate costs, and alleviate a significant financial burden – as well as a great deal of stress.
Medicare Supplement plans work with Medicare Parts A and B. This differs from Medicare Advantage plans, which replace your Medicare benefits with private coverage. With Medicare Supplemental Insurance plans, you continue to receive federal health care benefits while filling in the coverage gaps left behind by Parts A and B.
What to know when comparing Medicare Supplement Plans
Comparing Medicare Supplement plans can be difficult due to plan standardization – the only difference you will see is cost. Medicare Supplement plans are priced and sold by private insurance companies, but the benefits of the plans are standardized across the nation and structured exactly the same from company to company.
Because of this, Medigap policyholders can see any doctor who accepts Medicare patients—including those out of state. Medigap coverage goes with you anywhere you travel in the United States and is guaranteed for life if premiums are paid on time. Some Medigap plans also include international travel insurance coverage.
What isn't covered by Medicare Supplement Plans?
Medigap plans do not cover Dental, Vision, and Hearing insurance, long-term care, or prescription drug insurance, but they must cover at least a portion of the following basic benefits:
- Medicare Part A coinsurance costs up to a year after Medicare benefits are exhausted
- Medicare Part A hospice coinsurance care or copayments
- Medicare Part B coinsurance or copayments
- The first three pints of blood used in a medical procedure
Medicare Supplement plan options and comparison chart
There are 10 standard Medicare Supplemental Insurance plan types available in most states, each with an assigned letter from A to N (plans E, H, I, and J are no longer sold and Plans F and C are only available to those who were eligible for Medicare prior to Jan. 1, 2020). While these letters sound similar to Medicare Parts A and B, they are completely separate plans.
Medicare Supplement Plan Descriptions
What is the most popular Medicare Supplement Plan?
Two-thirds of Medicare enrollees who purchase a Medigap plan select Plan F. Medicare Supplement Plan F includes all Parts A and B deductibles, along with coinsurance and copayment of Part A hospice care and Part B outpatient services. Plan F also includes Part A coinsurance and hospital costs for an additional 365 days after your initial Medicare benefits have been used. As such, Plan F can help save thousands of dollars following an extensive hospital stay. High Deductible Plan F offers a low monthly premium in exchange for a high deductible but is available only to enrollees eligible for Medicare prior to 2020.
Because of that enrollment cut-off, Plan G is a popular subsititute.
Comparing Plan F vs. Plan G
Two of the most popular Medicare Supplement (or Medigap) plans are Plan G and Plan F. They both provide broad coverage, but they are not identical.
Medicare Supplement Plan comparison chart and additional benefits
Some Medicare Supplement plans may include additional benefits and are much more comprehensive. The Medigap plan comparison chart provides a convenient, compact way to compare plans in order to find the best option.
Note: In Massachusetts, Minnesota, and Wisconsin, Medigap policies are standardized differently.
* As of Jan. 1, 2020 Medicare Supplement plan types C and F will no longer be made available to beneficiaries who become Medicare-eligible after Dec. 31, 2019. For those who became Medicare-eligible prior to Jan. 1, 2020, Medicare Supplement plan types C and F will remain active and available for future enrollment.
1 Plans F and G also offer a high-deductible plan in some states. With this option, you must pay for Medicare-covered costs (coinsurance, copayments, and deductibles) up to the deductible amount of $2,700 in 2023 before your policy pays anything. (Plans C and F aren't available to people who were newly eligible for Medicare on or after Jan. 1, 2020.)
| Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ |
| Part B coinsurance or copayment | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | 50% | 75% | ✅ | ✅³ |
| Blood (first 3 pints) | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | 50% | 75% | ✅ | ✅ |
| Part A hospice care coinsurance or copayment | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | 50% | 75% | ✅ | ✅ |
| Skilled nursing facility care insurance | ❌ | ❌ | ✅ | ✅ | ✅ | ✅ | 50% | 75% | ✅ | ✅ |
| Part A deductible | ❌ | ✅ | ✅ | ✅ | ✅ | ✅ | 50% | 75% | 50% | ✅ |
| Part B deductible | ❌ | ❌ | ✅ | ❌ | ✅ | ❌ | ❌ | ❌ | ❌ | ❌ |
| Part B excess charge | ❌ | ❌ | ❌ | ❌ | ✅ | ✅ | ❌ | ❌ | ❌ | ❌ |
| Foreign travel exchange (up to plan limits) | ❌ | ❌ | 80% | 80% | 80% | 80% | ❌ | ❌ | 80% | 80% |
| Out-of-pocket-limit⁴ | N/A | N/A | N/A | N/A | N/A | N/A | $6,940 | $3,470 | N/A | N/A |
2 After you meet your out-of-pocket yearly limit and your yearly Part B deductible, the Medigap plan pays 100% of covered services for the rest of the calendar year.
3 Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don't result in inpatient admission.
Nearly two-thirds of Medigap policy holders traditionally enroll in Plan F because of its benefits and coverage. Unfortunately Plan F and Plan C are only available for those who became Medicare-eligible prior to Jan. 1, 2020. The closest replacement for these plans would be Plan G or Plan N.
Those who became Medicare-eligible prior to 2020 may keep an existing Plan F or C and may also apply for a new Plan F or C, even from a different insurance company.
Choosing your Medigap coverage level can be a difficult process. Each plan is unique and to find which plan best fits your needs, it’s highly recommended that you speak to a professional.
How and when to enroll in a Medicare Supplement Plan
You cannot enroll in a Medicare Supplement policy until you have Medicare Parts A and B, which for many people is age 65. After you have Original Medicare, you can choose to enroll in a Medigap policy during your Medigap Open Enrollment Period.
Medigap Open Enrollment Period
Your Medigap Open Enrollment Period starts at the beginning of the first month that you are both 65 years old and are officially enrolled in Medicare Part B. It lasts for six months after this date. So, for example, if you turn 65 in August but don’t start Medicare B until late September, your Medigap Open Enrollment Period will begin on October 1 and end April 1.
To help mitigate costs and get the best deal on your policy, you should enroll in a Medicare Supplement policy as soon as you are eligible.
During your six-month enrollment period, insurance companies are required by law to approve you for coverage regardless of any pre-existing conditions or health history. If you enroll after your Medigap Open Enrollment Period (for example, if you want to switch insurance carriers), you may have to answer health questions during a simple underwriting process, unless you have a guaranteed-issue right.
Delayed Part B Coverage & Medigap
If you are waiting to enroll in Medicare Part B because you or your spouse are working and have coverage through your employer or union, your Medigap coverage will not begin until you officially enroll in Part B. But, if you enroll while you still have employee-sponsored coverage, your Medigap Open Enrollment Period will begin from that date, even if your employer coverage is still in place. We help people across the country navigate this type of decision every day.
To help mitigate costs and get the best deal on your policy, you should enroll in a Medicare Supplement policy as soon as you are eligible.
During your six-month enrollment period, insurance companies are required by law to approve you for coverage regardless of any pre-existing conditions or health history. If you enroll after your Medigap Open Enrollment Period (for example, if you want to switch insurance carriers), you may have to answer health questions during a simple underwriting process, unless you have a guaranteed-issue right.
Medicare Supplement basic costs
Medicare Supplement plan costs vary by company and plan letter. Like with most insurance, the plans with the highest benefit levels will typically be more expensive up front, but come with little to no out-of-pocket costs. If you want to pay a lower monthly premium and are okay with paying more as you go, you can choose a plan with fewer benefits but lower monthly costs.
How are costs calculated?
Although Medigap plans are federally standardized in terms of basic benefits, private insurance companies can charge different premiums. Factors that can affect your premium include your age, location, gender, and (in some states) whether you use tobacco products.
There are three pricing methods that affect long-term Medigap costs. When you enroll in a policy, you should make sure you understand which pricing method your plan follows. It’s worth noting that depending on where you live in the country, you may only have one of these options available.
- Attained-age-rated policies
These plans have premiums that increase as you age. - Issue-age-rated policies
These plans have premiums that increase due to inflation, not due to aging. - Community-rated policies
With these plans, everyone in an area is charged the same premium regardless of age.
How can I save on premiums?
Once you settle on the benefit level that best fits your health care needs, the easiest way to save money on Medicare Supplement insurance is to comparison shop different insurance companies. Simply put, this is where United Medicare Advisors can help. We save our clients an average of $634 when switching Medigap plans and have helped over 400,000 people nationwide navigate their options.
How are costs calculated?
Although Medigap plans are federally standardized in terms of basic benefits, private insurance companies can charge different premiums. Factors that can affect your premium include your age, location, gender, and (in some states) whether you use tobacco products.
There are three pricing methods that affect long-term Medigap costs. When you enroll in a policy, you should make sure you understand which pricing method your plan follows. It’s worth noting that depending on where you live in the country, you may only have one of these options available.
- Attained-age-rated policies
These plans have premiums that increase as you age. - Issue-age-rated policies
These plans have premiums that increase due to inflation, not due to aging. - Community-rated policies
With these plans, everyone in an area is charged the same premium regardless of age.
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Frequently Asked Questions about Medicare Supplement plans
When is the best time to buy a Medicare Supplement Plan?
When you’re 65 and you have Medicare Part B, a period called the Medigap Enrollment Period automatically begins. This is the best time to buy a Medicare Supplement Plan, as you can buy any Medigap policy sold in your state. Because of Guaranteed Issue, during this period the underwriting process is unnecessary, generally giving you better prices and more policy options.
