Medicare Supplement Plan
Medicare Supplement Plan
Medicare Supplements or Medigap plans are Medicare Advantage plans that are designed to fill in the “gaps” in original Medicare. They are also sold by private companies and they work to “supplement” original Medicare.
Original Medicare will not pay for all your covered healthcare services and supplies but a Medicare Supplement plan can help cover your out of pocket expenses associated with original Medicare like copayments, coinsurance, and deductibles. Additionally, some Medicare Supplement plans will cover additional benefits that are not covered by original Medicare.
Medicare Supplement plans do not include drug coverage so you if you would like to have prescription drug coverage then you will need to add on a stand-alone drug plan as well.
Who is Eligible to Join a Medicare Supplement Plan?
In order to enroll into a Medicare Supplement plan, a Medicare beneficiary needs to be entitled to Part A and enrolled in Part B of original Medicare. You must purchase a Medicare Supplement plan from a company that’s licensed in your state to sell Medicare Supplement plans. Medicare Supplement plans with have different “guaranteed issue” periods during your eligibility for Medicare depending on the plan and the state that you live in. If you try to enroll in a Medicare Supplement plan outside of one of these “guaranteed issue” periods you will need to pass through medical underwriting, and you could be denied for the plan.
How Much does a Medicare Supplement Plan Cost?
The Cost of your Medicare Supplement plan could vary significantly depending on several factors including your age, your zip code, or your health status, the type of plan you choose and whether you qualify for guaranteed issue. The most popular plans will have a higher monthly premium but cover more of the gaps in original Medicare and provide the beneficiary with more predictable out of pocket expenses.
Medicare Supplement plans do not have a network of doctors so you may utilize your care from any doctor who accepts Medicare without a referral or prior authorization. Initially Medicare will pay its share and then your Medicare Supplement plan will pay its share. Now you may be eligible to early enrollment discounts or lower premiums if you bundle your supplement plan with your spouse. It is critically important to understand how your supplement plan is rated as well as any discounts that you may be eligible for in order to find that plan that fits your needs and budget.
* 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 $2,340 in 2020 ($2,370 in 2021) before your policy pays anything. (Plans C and F aren't available to people who were newly eligible for Medicare on or after January 1, 2020.)
** For Plans K and L, 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.
*** 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.