What is a Medicare Supplement Plan?
What a Medicare Supplement plan does is fill in the gaps not covered by Original Medicare. Also known as a Medigap plan, it pays the bills that Medicare Part A and Part B would normally charge you. These plans pay your share of Medicare expenses, including deductibles and co-insurance. Supplements benefit people who want little out-of-pocket costs for healthcare services.
Finding the best Medicare supplement coverage can be a confusing process with numerous options and confusing terms. Having some help comparing and navigating Medicare supplement policies can make a big difference. Our team at Senior Healthcare Direct provides expert agents to help personalize solutions for seniors looking for coverage.
Also keep in mind that Medicare Advantage supplemental benefits differ from Medigap. Let our professionals help you navigate those differences, so you can make the best decision for your needs.
How Does A Supplement Plan Help?
What is great about a Medicare Supplement plan is it provides you the freedom of nationwide coverage.
Medicare only covers 80% of your Part A and Part B expenses. So you may be stuck paying 20% of your hospital and medical bills. This 20% can be devastating to you financially if you have a serious illness. What a Medicare Supplement plan does is fill this 20% gap and buy you peace of mind.
Medigap plans may cover most or all coinsurance costs for hospitals, skilled nursing facilities, hospice care, and part-time home health services. Most importantly, Medigap plans pay your $1,600 Part A deductible in 2023 for every 60-day benefit period.
What Else Do Medigap Plans Cover?
A Medicare Supplement plan may cover coinsurance or copay costs for Part B medical services and supplies, including:
Doctors Visits
Outpatient Procedures
Durable Medical Equipment
Lab Work
What a Medicare Supplement plan does is provide coverage for copays, coinsurnace and deductibles. To obtain it, you must have Medicare Part A and Part B. Medigap policies only provide coverage for one person, which means you and your spouse need separate policies if desired. Numerous plan options exist. Medicare Plan F and Medicare Plan G, offer high-deductible plans (available in some states). Working with our experts, we can help you navigate each of these Medicare Supplement plans to find the one that best fits your needs.
Keep in mind that Medigap Supplemental insurance does not cover all types of care. It does not typically cover long-term care, vision, dental care, hearing aids, private-duty nursing needs or prescription drugs.
The Value Of Medigap Insurance
The value of a Medigap plan maybe more than you think. If you have a hospital stay for more than 60 days without Medigap, you will have $400 coinsurance per day. Moreover, if your hospital stay is more the 90 days without Medigap, you will have $800 coinsurance per day.
What a Medicare Supplement plan does is pay this expensive hospital coinsurance. As a result, you can stay in the hospital as long as needed without worrying about the cost. Furthermore, Medigap Plans give you these benefits:
You can choose any doctor and hospital that accepts Medicare
No referrals required to see a specialist
No claim paperwork – claims are automatically filed with your supplement company
Medicare Parts Vs. Medigap Plans
Although the names sound similar, Medicare Parts such as Part A and Part B is not the same as Medigap Plan A, Plan B, etc. To buy a supplement policy you must have Medicare Part A and Part B. Learn more about the 4 Parts of Medicare.
Medigap Plans only cover one person. So your spouse or other family member must have a separate supplement policy. When you enroll two or more people, you can get a household discount and save money on your monthly premiums. Non-smokers can get additional discounts, as well. Call Senior Healthcare Direct to speak to a licensed agent at 1-833-463-3262 and find out how much you can save.
Furthermore, Medigap Plans do not include drug coverage. So if you need prescription drugs, you can add a separate Part D drug plan.
More Common Questions about Medicare Supplements
What is the difference between Medicare Supplement and Medigap?
Medigap is another name for Medicare Supplement. Hence, both names refer to the same thing.
What if I already have Plan C or F?
As of January 1, 2020, Medigap plans will not cover the Part B deductible ($226 in 2023). Therefore, Plans C and F will no longer be available for people new to Medicare after January 1, 2020. If you already had either of these two plans (C or F), you can keep your plan.
Can I buy Medigap if I lose my health coverage?
Yes, you may have a guaranteed issue right to buy a Medigap policy. It is most important you keep these documents: Copy of any letters, notices, emails, and/or claim denials with your name on them. This proves your coverage is terminated.
When is the best time to buy a Medigap Plan?
The best time to buy a Medigap policy is the 6-month period starting the first day you turn 65. For example, you turn 65 in March and enroll in Part B, then best time to buy a Medicare Supplement Plan is from March to August.
Does Medigap cover pre-existing conditions?
In some cases, the supplement insurance company can refuse to cover your out-of-pocket costs for pre-existing health problems for up to 6 months. This is called a “pre-existing condition waiting period.” After 6 months, the Medigap policy will cover the pre-existing condition.
What is a ‘Look Back’ Period?
A condition treated or diagnosed within 6 months before your Medigap coverage starts.
Medigap coverage is excluded for conditions in the ‘Look Back Period.’ Your original Medicare will still cover the condition, but you will be responsible for paying 20% co-insurance and copays.
Medicare Supplement Guarantee Issue
Guaranteed issue rights are rights you have in certain situations where Medicare supplement company must offer you certain Medigap policies when you are not in your Medigap open enrollment. Some common situations where you have guaranteed issue rights to apply for a Medigap policy include:
Medicare Advantage Plan is leaving Medicare or stops providing care in your area or you move out of the plan’s service area. You can apply as early as 60 days before your health coverage ends. Otherwise, you only have 63 days after your coverage ends.
When you have Original Medicare and your employer group health coverage is ending. Rights are guaranteed if you apply no later than 63 days after your group coverage ends.
When you have Medicare and Medicare Select policy and you moved out of the Medicare Select service area. You can apply as early as 60 days before Medicare Select coverage ends. Otherwise, you only have 63 days after Medicare Select coverage ends.
Within the first year of enrolling in Medicare Part A at age 65 you decide to switch from Medicare Advantage Plan or PACE. You can apply as early as 60 days before your coverage ends. Otherwise, you only have 63 days after your coverage ends.
You dropped a Medigap policy to join a Medicare Advantage Plan for the first time and within the first year. You can switch back to Medigap within 63 day after your coverage ends.
In general, guaranteed issue time period works just like open enrollment, except that it’s shorter time frame.
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