Medicare Supplement Plans in Oregon
Medicare Supplement plans, sold by private insurance companies, can help pay some of the remaining Original Medicare health care costs, like deductibles, copayments, and coinsurance. Medicare Supplement plans are also called Medigap plans. Some Medigap plans also offer coverage for services that Original Medicare doesn't cover, like emergency medical care when you travel outside the U.S. Medigap plans are only required to cover the benefits and services Original Medicare covers.
Medigap policies are standardized.
Medigap plans are subject to state and federal regulations. As of June 2010, insurance companies can sell you only a "standardized" policy. Plans are identified by letters A, B, C, D, F, G, K, L, M, N and are offered by private insurance companies. (Not all plans are offered in all states or by all insurance companies.) Standardized means that all of the policies offer the same benefits for each plan letter, but each plan letter provides different coverage. Although the policies have the same benefit structures per plan letter, the insurance companies can charge different premiums based on age, gender, zip code, tobacco use, weight, and medical conditions.
Starting January 1, 2020, Medigap plans sold to people new to Medicare won’t be allowed to cover the Part B deductible. Because of this, Plans C and F will no longer be available to people who are new to Medicare on or after January 1, 2020.
If you already have either of these two plans (or the high deductible version of Plan F) or are covered by one of these plans prior to January 1, 2020, you'll be able to keep your plan. If you were eligible for Medicare before January 1, 2020 but not yet enrolled, you may be able to buy one of these plans.
People new to Medicare are those who turn 65 on or after January 1, 2020, and those who get Medicare Part A (Hospital Insurance) on or after January 1, 2020.
Comparing Medigap policies.
The chart below shows basic information about the different benefits that Medigap plans cover. If a percentage appears, the Medigap plan covers that percentage of the benefit, and you are responsible for the rest.
* Plans F and G also offer a high-deductible plan in some states. (Plan F isn't available to people new to Medicare on or after January 1, 2020.) If you get the high-deductible option, you must pay for Medicare-covered costs (coinsurance, copayments, and deductibles) up to the deductible amount of $2,490 in 2022 before your policy pays anything, and you must also pay a separate deductible ($250 per year) for foreign travel emergency services.
**For Plans K and L, they show how much they'll pay for approved services before you meet your out-of-pocket yearly limit and your Part B deductible ($233 in 2022). After you meet these amounts, the Medigap plan pays 100% of approved services for the rest of the calendar year.
*** 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 an inpatient admission.
Additional Information
- You must be enrolled in Medicare Part A and Part B in order to enroll in a Medigap plan.
- You must continue to pay your Part B premium in addition to the Medigap monthly premium to the private insurance company.
- Medigap policies are individual and only cover one person.
- Standardized Medigap policies do not include prescription drug coverage.
- Original Medicare is the primary payer and the Medigap plan will be secondary payer.
- Medigap plans generally accepted by doctors that accept Original Medicare.
- Your open enrollment period, which provides guaranteed acceptance, begins on the first day of the month in which you're both 65 or older and enrolled in Medicare Part B for the first 6 months.
- Federal law doesn't require insurance companies to offer Medigap policies to people under age 65. So, if you're under 65, you might not be able to buy a Medigap policy until you turn 65.
Choosing a Medigap policy can seem confusing. At SeniorChoices NW, we can help you understand your options so you can make an informed decision. Email us today, or call toll-free at 503-682-1878.