Medicare Supplement Plans
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.
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.
* Plan F also offers a high-deductible plan in some states. If you choose this option, this means you must pay for Medicare-covered costs (coinsurance, copayments, and deductibles) up to the deductible amount of $2,200 in 2017 before your policy pays anything.
** 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.
(Chart and info by medicare.gov)
- 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 866-682-1878.