Medicare Supplement Insurance Plans also known as Medigap Plans Provide the Best and Most Comprehensive Coverages Including:
- No Out-Of-Pocket Costs.
- No Co-Payments for Doctors.
- No Referrals Necessary.
- No Deductibles for Hospitals.
- Choice of Any Doctor, Any Hospital, Any Medical Facility that accepts Medicare Anywhere in the United States.
- Coverage is Guaranteed Renewable which means your coverage cannot be denied as long as you continue to pay the premiums each year.
- Coverage goes with you when traveling, moving or selecting a doctor anywhere in the United States.
A Medicare supplement insurance plan helps cover the “gaps” in coverage that are left unpaid after original Medicare pays its portion of your health care expenses. For this reason, these plans are often referred to as Medigap plans, Medicare Supplemental Insurance or Med Supp. Medicare Supplement plan and Medigap plan are synonymous and will be used interchangeably in discussion.
Medicare has been standardized into ten plans labeled A through N, each with its own set of benefits. Medicare Supplement policies are sold by private insurance companies. While the costs of these policies may vary, individual insurance companies must provide identical benefits as outlined by law. In order to enroll in a Medigap Plan, you must be enrolled in Medicare Part A and Part B or intend to enroll in Part A and B soon. Most insurers will accept applications for you Medigap policy as long as your application is submitted not much more than 2 months before your enrollment in Medicare Part B.
Medicare Supplement policies allow you to choose any doctor and any hospital anywhere in the USA. Unlike HMO’s, you do not need a referral or pre-authorization to see a doctor or to be admitted to a particular hospital. Medicare supplements allow you to be in charge of your health care. This is especially important for those coming into open enrollment that may already have health problems. During open enrollment, you can enroll in a Medicare Supplement plan without having to answer heath questions. Medicare Supplement policies currently being offered cannot be cancelled by the insurance company based on your personal claims experience – unless you stop paying your premiums.
Most companies offering Medicare Supplement Insurance have automatic claims filing. That means you do not have to worry about filing a claim with Medicare or your insurance company. With Medicare claims, your doctor submits an approved medicare service bill to Medicare, Medicare approves the claim, pays its portion to the doctor, then Medicare submits the remaining portion for payment to the insurance company
The Medigap Plans are listed below. Most of the plans have out-of-pocket expenses that result from 2 deductibles called Part A Hospital Deductible and Part B Doctors Deductible. Plans K and L have higher out-of-pocket expenses on an annual basis but at least you have plans where you get to choose any doctor and hospital that accepts medicare. If Medicare does not approve your medical claim, then call us and we will help to resolve it for you.
Medicare Part A Deductible ($1,480 in 2021)
Medicare Part B Deductible ($203 in 2021)
Medicare has an annual deductible of $203.00 for Part B charges. Some policies pay this deductible but you may pay more than $203.00 in additional premium each year if you select a policy that provides this benefit.
Typically Medicare does not pay for routine Nursing Home Care. Care for those that cannot perform routine activities of daily living falls under long term care insurance. Be sure you thoroughly understand the Skilled Nursing Benefit in Part A of Medicare.
Check with your doctors to see if they “Accept Assignment” before purchasing a Medicare Supplement Policy. If all of your doctors “Accept Assignment” you may not need to spend the extra money for Plans that pay for Excess Charges. See page for more information.
Anyone that currently has a Medicare Supplement policy and is looking to lower their premiums with the same or lesser benefits then there cannot be a waiting period imposed for pre-existing conditions. You may, however, have to answer health questions on the application. If you cannot answer the questions successfully the company will not issue the policy.
A Medicare Supplement insurance plan can be used to help cover certain out-of-pocket costs that Medicare Part A and Medicare Part B (Medicare) don’t pay. The “gaps“ in Medicare that Medicare Supplement insurance plans help cover may include coinsurance, copayments, and deductibles. Ten different Medicare Supplement insurance plans, labeled A, B, C*, D, F*, G, K, L, M and N, are available in most states through private health care insurers. Each standardized plan has a different level of coverage. (Massachusetts, Minnesota, and Wisconsin have their own standardized Medicare Supplement insurance plans.)
Medicare Supplement insurance Plan A is not to be confused with Medicare Part A. Medicare Part A covers inpatient hospital care and is one half of Medicare (Part A and Part B). Medicare Supplement insurance Plan A refers instead to coverage that helps pay for out-of-pocket costs from Medicare Part A and Part B
What Medicare Supplement insurance plans only in Wisconsin, Minnesota and Massachusetts have?
Wisconsin, Minnesota, and Massachusetts handle Medicare Supplement insurance plans differently than other states. Each of these states has a list of “basic benefits” that every Medicare Supplement insurance plan in the state must cover at a minimum.
Medicare Supplement insurance (also known as Medigap insurance) may cover some of your out-of-pocket costs that you normally have to pay with Original Medicare, Part A and Part B. These expenses may include copayments, coinsurance, and deductibles. Medigap plans may help you pay for additional medical expenses resulting from unexpected procedures and hospitalization. This article focuses on Medigap Plan B.
Medigap Plan B is one of 10 standardized Medigap plans available in most states (Massachusetts, Wisconsin, and Minnesota have their own standardized plans). The various Medigap plan types cover different amounts of your Medicare out-of-pocket costs.
Medicare Supplement (Medigap) Plan A
Not to be confused by Medicare Part A that you have been paying into for many yearsIt is the most basic of the 10 Medicare Supplement Insurance Plans. It still covers the most important benefit, which is the 20% of outpatient medical care that Medicare doesn’t cover
Medicare Supplement Plan B
also called Medigap Plan B, offers the same benefits as Plan A. In addition, it will also pay your Part A hospital deductible for you. This is a significant benefit as the Part A deductible is over $1,400, and tends to go up slightly each year. Having Medigap Plan B means that you will never have to worry about that deductible going up.
Your hospital deductible is a per-incident deductible, not an annual one, so this is an important benefit. Medicare Plan B will pay the deductible even if you incur it more than once in the same year.
Medicare Supplement (Medigap) Plan F
Is no longer an option for those who are new to Medicare.
Medicare Supplement (Medigap) Plan G
Medicare Supplement Plan G covers your share of any medical benefit that Original Medicare covers, except for the outpatient deductible. Click here for more information
Supplement (Medigap) Insurance Plan K
Medicare Plan K is the Medicare Supplement that covers the Part A hospital deductible while also covering about 50% of the other gaps in Medicare. It also includes a cap on your spending called an out-of-pocket maximum. Medigap Plan K’s cap is $6,220 in 2021. Click here for more information
Medicare Supplement (Medigap) Plan L
Medicare Supplement Plan L is another cost-sharing Medigap policy. In exchange for slightly lower premiums than what you might pay for a Plan F, if you enroll in a Medigap Plan L, the insurance carrier will pay 75% of your covered medical expenses on most items, and you will pay the other 25%. You also agree to pay the Medicare Part B deductible and any excess charges on your own.
A Plan L Medigap policy also includes a cap on your expenses. This is referred to as your out-of-pocket limit or maximum. Medicare sets this limit annually, and in 2021, the limit for Plan L is $3,110.
Medicare Supplement (Medigap) Plan M:
Plan M provides the same basic benefits as other Supplements. However, it has a slightly reduced monthly premium in exchange for your willingness to pay half of your hospital deductible and all of your annual outpatient deductible. By sharing in these deductibles as well as excess charges, you get the benefit of reduced premiums. Click here for more information
Medicare Supplement (Medigap) Plan N
This standardized Medicare Supplement covers the 20% that Medicare Part B doesn’t. It also pays for your hospital deductible and all your hospital copays and coinsurance. Part B deductible, and some small copays at the doctor’s office and the emergency room.