What are Medicare Supplement Plans?

Are you thinking about getting a Medicare Supplement Plan to cover some gaps in your Original Medicare? This article will help you understand these plans and decide if they're right for you.

How Do Medicare Supplement Plans Work?

Medicare Supplement plans, also known as Medigap plans, provided by private insurance carriers, 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 plan 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.

Why Consider a Medicare Supplement Plan?

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.

Can I Have Employer Insurance and Medicare?

Yes, you can have both employer insurance and Medicare, but it depends on the size of the company you or your spouse work for:

• Fewer than 20 Employees: You should enroll in Medicare because employer insurance becomes secondary once you’re eligible for Medicare.

• 20 or More Employees: You can delay enrolling in Medicare since your employer insurance is considered creditable coverage. This gives you a Special Enrollment Period when you’re ready to enroll in Medicare.

What is Medigap?

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

*Note: these plans are medically underwritten and the applicant may be denied for plan enrollment.

Medicare Part A: Hospital and Skilled Nursing Fees

Gap 1: You have a $1,632 deductible for up to 60 days in the hospital.

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.

Gap 3: For skilled nursing, the first 20 days are free, but days 21 to 100 have a $204 daily copay.

Medicare Part B: Outpatient and Doctor Services

Gap 1: There’s an annual $240 deductible.

Gap 2: After meeting the deductible, you pay 20% of the bill (coinsurance).

Gap 3: Some doctors charge more than Medicare’s approved rates, and you might have to pay up to 15% extra.

When Can You Change Medicare Supplement Plans?

You can change your Medigap plan anytime. You may be required to go through the underwriting process again unless you meet certain conditions that would support guarantee issue. UnderwitingUnderwriting 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.

How Much Do Medicare Supplement Plans Cost?

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

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

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.

Medicare Supplement Plan G: Covers all but the Part B deductible. The average premium starts at $125 per month.

Medicare Supplement Plan N: Covers most gaps but includes copays for doctor and ER visits. The average premium starts at $100 per month.

Medigap vs. Medicare Advantage

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

Making Your Choice

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.

We’re Here to Help!

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.

Gain a Better Understanding of Medicare

For more information on your Medicare options, read our other articles below or schedule time with a Medicare Champion today!

What is Medicare?

Start with the Medicare basics.

Learn more --> https://mymedicarechampion.com/picking-medicare

Medicare Enrollment

How do you enroll in Medicare? How does Medicare work with other insurance?