What is a Medicare Supplement?
A supplement plan can provide much-needed financial help with medical costs for those on Medicare. Also known as Medigap, these supplemental insurance plans help cover the gaps in Medicare coverage, such as deductibles, coinsurance, and copayments. Although Medicare offers good basic insurance, it only pays about 80%, leaving you on the hook for everything else. There are ten different Medicare supplement plans available, each with varying levels of coverage. Here’s a quick overview of the various options.
Plan A Medicare Supplement (Medigap) Plan A is not the same as Medicare Part A, but is one of the Medicare Supplemental insurance plans available to Medicare beneficiaries. It is a basic plan that covers:
- Medicare Part A coinsurance payments up to an additional 365 days after Original Medicare benefits are exhausted
- Medicare Part B copayment or coinsurance expenses
- The first three pints of blood used in a medical procedure
- Part A hospice care coinsurance expense or copayment
Medicare Supplement Plan A has the fewest individual benefits of the ten standardized Medicare Supplement insurance plans available in most states.
Plan B According to Medicare.gov website , Medicare Supplement Plan B coverage includes:
- Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up.
- Part B coinsurance and copayment.
- The first three pints of transfused blood.
- Part A hospice care coinsurance or copayment.
- Part A deductible.
Keep in mind that all Medicare Supplement Plan B policies cover the same expenses no matter which company’s plan you choose. The same is true of all the Medigap policies: Those within the same letter cover the same expenses.
Plan CMedicare Supplement (Medigap) insurance Plan C is one of the most comprehensive of the 10 standardized Medigap insurance plans available in most states. Out of the 10, only Medigap Plan F offers more coverage. Medigap Plan C covers most Medicare-approved out-of-pocket expenses.
However, Medicare Supplement Plan C is being phased out, along with Plan F. Be aware that if you become eligible for Medicare on or after January 1, 2020, you won’t be able to buy Plan C. If you already have Plan C, don’t worry – you can generally keep your plan. You can apply to buy Plan C if you become eligible for Medicare before 2020.
Plan CMedicare Supplement (Medigap) insurance Plan C is one of the most comprehensive of the 10 standardized Medigap insurance plans available in most states. Out of the 10, only Medigap Plan F offers more coverage. Medigap Plan C covers most Medicare-approved out-of-pocket expenses.
However, Medicare Supplement Plan C is being phased out, along with Plan F. Be aware that if you become eligible for Medicare on or after January 1, 2020, you won’t be able to buy Plan C. If you already have Plan C, don’t worry – you can generally keep your plan. You can apply to buy Plan C if you become eligible for Medicare before 2020.
Plan FPlan F is the easiest of the Medicare supplement plans to explain, all you pay is your monthly premium & Plan F pays all deductibles and coinsurance. This plan has be pulled off the market for new Medicare enrolled. If you turned 65 on or after January 1st 2020 this plan will not be available. However anyone already on the plan may keep it.
Plan G is like Plan F, but it doesn’t cover the Part B deductible. It does, however, provide for the Part B excess charges. The comprehensive care includes foreign travel emergency, hospice care, and skilled nursing. Plan G has become one of the most popular plans nationwide the removal of Plan F & C.
Plan K covers the part A coinsurance and hospital costs and 50 percent of Part B copayments, and 50 percent of Part A hospice, skilled nursing, and the Part A deductible. It doesn’t pay any part of the Part B deductible, Part B excess charges, or foreign travel emergencies.
Plan LHere’s where the different Medicare Supplement plans get even more confusing. Plan L is like Plan K, with a few exceptions. It covers 75 percent of everything Plan K offers and 50% of the Part A deductible, and it adds 80% coverage for foreign travel care.
Plan MMedicare Supplement Plan M covers the following Medicare expenses:
- Medicare Part A coinsurance
- Medicare Part B coinsurance or copayment
- Blood (first three pints) (75%)
- Part A hospice care coinsurance or copayment
- Skilled nursing facility care coinsurance
- Medicare Part A deductible, which is $1,556 in 2022 (50%)
- Medigap Plan M only covers half of the Medicare Part A deductible. Part A covers your inpatient services, so you’d only receive a bill if you’re admitted to the hospital for treatment. If you have Plan M in 2022, you’d have to pay half for the deductible instead of the full $1,556.
Plan NThis Plan covers 100% of part A coinsurance and deductible.On the out patient side it does not cover the part B deductible which for 2022 will be $233 and it a maximum cost of $20 for offices visits and $50 for a emergency room visit. This plan is very popular in my home state of N.Y and can be a more cost effective option for those on a tight budget.
eWhat’s the Difference Between a Medigap Policy and Medicare Advantage Plan?Medicare Advantage Plans are an alternative to the original Medicare program. They’re offered through private insurance companies and provide a wide range of coverage. Essentially they provide all the coverage that original Medicare does as good or better,plus they usually offer extra benefits like part D prescription coverage, dental, vision , hearing ect. These plans typically have low or no premium and can be quite attractive to the right consumer. Unlike Medicare supplements these plans generally have networks of providers like HMO or PPO. So network restrictions may be an issue for some.
How Do I Choose Between a Medicare Advantage Plan and a Medicare Supplement Plan?I always making a list of must haves and what is most important to you in a health plan. There is no one best plan for all and both plans work well as long as the consumer has proper expectations.
Medicare supplements will give you more flexibility since they have no provider networks and allow you to use any Medicare doctor or hospital in the country. They also tend to have more comprehensive coverage toward hospital stays and the popular supplement plans F,G & N have very little out of pocket at all except premium. So if you like the all inclusive style that offers total freedom of provider choice this may be a good choice for you.
If on the other hand you’re like a lot of my clients who do not go to the doctors much and are generally healthy and would prefer to pay for services as you used them rather than pay a high premium up front. Then getting a Medicare advantage plan that includes part D and maybe some dental and vision may be the choice for you. There are many options and depending where you live they can vary greatly in price and coverage when it comes to Medicare advantage plans.
You don’t have to make this decision alone,
An Independent agent can help you understand the different plans and find the one to fit your needs. They are up-to-date with the latest changes in Medicare and can explain complex topics in simple terms, so you make the best decision for you. To schedule an appointment to review your options, contact us today.