Medicare Supplement (Medigap) Plans

Medicare Supplement plans, also known as Medigap plans, work with your Original Medicare. When you get medical services, your provider bills Medicare first. Medicare pays its part and then sends the rest of the bill to your Medigap provider. The amount you owe depends on your specific Medigap plan. These plans don’t need pre-authorization and you can keep them for life if you keep paying for them. Plus, they work nationwide, just like Original Medicare.

Choosing the right Medicare option can be confusing. While Medicare Parts A and B cover a lot, you’ll still have out-of-pocket costs. This is where Medicare Supplement plans, also known as Medigap plans, come in handy. Medigap plans help fill the gaps in your Original Medicare coverage, helping you manage costs like deductibles, coinsurance, and copays. Knowing how these plans work can help you get the complete healthcare coverage you need in retirement.

Medigap plans are extra insurance that helps cover the costs not covered by Original Medicare. These plans are offered by private insurance companies. They may help you pay for things like deductibles, coinsurance, and copays.

1. Gap 1: You have a $1,632 deductible for up to 60 days in the hospital.
2. Gap 2: For stays beyond 60 days, there’s a $408 daily copay for days 61 to 90 and an $816 daily copay for days 91 to 150.
3. Gap 3: For skilled nursing, the first 20 days are free, but days 21 to 100 have a $204 daily copay.Gap 1: You have a $1,632 deductible for up to 60 days in the hospital.
4. Gap 2: For stays beyond 60 days, there’s a $408 daily copay for days 61 to 90 and an $816 daily copay for days 91 to 150.
5. Gap 3: For skilled nursing, the first 20 days are free, but days 21 to 100 have a $204 daily copay.

1. Gap 1: There’s an annual $240 deductible.
2. Gap 2: After meeting the deductible, you pay 20% of the bill (coinsurance).
3. Gap 3: Some doctors charge more than Medicare’s approved rates, and you might have to pay up to 15% extra.

You can change your Medigap plan anytime. You may be required to go through the underwriting process unless you meet certain conditions that would support guarantee issue. Underwiting means the insurance company can review your health and decide your premium. If your healthcare needs change or if you find a better plan, you might want to switch. Talking to a licensed Medicare Champion can help you understand your options and make a smooth transition.

The cost of Medigap plans varies based on your provider, location, and health. On average, people pay about $155 per month.

There are multiple Medigap plans, but only some are available to everyone. Here are the three most common plans:

1. Medicare Supplement Plan F: Covers all gaps in Original Medicare. Only available to those born before January 1, 1955. The average premium starts at $175 per month.
2. Medicare Supplement Plan G: Covers all but the Part B deductible. The average premium starts at $125 per month.
3. Medicare Supplement Plan N: Covers most gaps but includes copays for doctor and ER visits. The average premium starts at $100 per month.

When filling the gaps in Original Medicare, you might consider a Medigap plan or a Medicare Advantage plan. Here are the differences:

• Medigap works with Original Medicare, while Medicare Advantage replaces Original Medicare.
• Medigap lets you see any doctor that accepts Medicare. Medicare Advantage may have network restrictions.
• Medicare Advantage plans often have lower premiums and may cover more services, but Medigap plans typically have lower out-of-pocket costs.

Choosing the right plan depends on your needs and budget. Consider what’s most important for your healthcare and financial situation to decide which plan suits you best.

For more information and personalized help, call a licensed Medicare Champion where we can help you find supportive and caring guidance tailored just for you.