Medicare Supplement Plans
Medicare Supplement Plans (MS), also referred to as Medigap insurance, are private health insurance policies that help cover expenses not paid for by Original Medicare, also called Part A and B. These expenses can include copayments, deductibles, and coinsurance. Some plans even help cover medical costs incurred during travel to other countries. If you’re one of the 60% of seniors who say traveling is their number one most important retirement goal, buying a Medigap plan is one way to help you stay covered while away from home.
Part A and B doesn’t cover many expenses—leaving some people with high out-of-pocket costs. For example, Part B generally covers 80% of medically necessary services, and there is no out-of-pocket limit, meaning costs can add up. Medigap helps cover the 20% of leftover costs.
Still, it doesn’t cover everything. In general, services like vision and dental care, hearing aids, long-term care, and private nursing are not covered. If you’re looking to get coverage that includes some of these extra benefits, you may want to consider an Advantage (MA) plan.
You cannot have both an MS plan and an MA plan, as Medigap is designed to help offset some of the costs of Part A and B—not Part C. If you have an Advantage plan, you may be able to apply for a Supplement plan, but you must be sure to leave the Advantage plan and move back to Part A and B before the policy goes into effect.
Keep reading to learn more about supplement plans—and decide if they’re right for you.
The ABCs: You have an alphabet of plan options.
The 10 different plans are named using a letter of the alphabet: A, B, C, D, F, G, K, L, M, and N. Each plan includes a unique set of benefits, which are standardized by law.* Because private insurance companies offer supplemental insurance, the options available to you depend both on your state’s laws and on what each insurance company is willing to offer.
All companies that offer Medigap plans must offer Plan A. Also, Plans C and F must be offered if a company provides any plans besides Plan A.
Because these plans are standardized, you can focus on which set of benefits is right for you and compare costs to decide which company to go with.
*Massachusetts, Minnesota, and Wisconsin standardize plans differently than the rest of the country. If you live in one of these states, contact one of our licensed sales agents who can help you understand your options. You may also contact your local state insurance department.
For a comparison of all Medigap plans, read the chart below.
Only two plans, C and F, offer coverage for the Part B deductible, referred to as “first-dollar coverage.” This means that the plan will start paying its part before you meet your deductible. If you have a plan without first-dollar coverage, you must first meet your deductible. Note that according to Modern Healthcare magazine, the government is phasing out Plans C and F by 2020.
Plan F provides the most complete coverage, followed by Plan C and Plan G. Because these plans cover more, they are typically more expensive than plans with modest coverage.
If you’re looking for more middle-of-the-road coverage, Plans K and L may be good options. They offer moderate premiums with some cost-sharing (coinsurance) for reimbursed services. These plans also have out-of-pocket limits, which cap the amount you’ll have to pay for care each year.
For less expensive plans, you may want to look at Plans A and B, which offer basic coverage on coinsurance and copayment for Parts A and B, but not much more.
If you are a frequent overseas traveler, consider Plans C, D, F, G, M, or N. These plans include coverage for some foreign travel emergencies.
Plan C and Plan F are most popular.
Among the 10 options, plans C and F account for more than half of all the plans bought, according to Kaiser Family Foundation. Here’s a breakdown of the biggest benefits you’ll see with these popular plans:
- Plan C offers wide coverage, including Part A and Part B deductibles and copayments. This plan helps pay for hospital, medical, hospice, skilled nursing, and some foreign travel emergency services.
- Plan F provides the most complete coverage. It covers everything Plan C does—plus it helps pay for Part B excess charges. You also have the option to buy a high-deductible version of Plan F. Read more details about this popular plan on our Plan F page.
Your costs for supplemental insurance can vary.
Although insurance companies must offer the standardized set of benefits for each lettered plan, the costs for each plan vary between companies. Insurance companies have a few different ways of pricing plans, and rates can change as different factors come into play. For this reason, it’s important to understand the difference between attained-aged vs. issue-age vs. community-rated pricing approaches to find a plan that can meet both your health and budget needs.
These are the three main approaches insurance companies take for “rating,” or pricing, a policy:
- Community-Rated (No Age-Rated) Pricing: Your premium is not based on age, but may increase due to inflation and other factors.*
- Issue-Age-Rated (Entry Age-Rated) Pricing: Premiums are lower for younger buyers and will not increase based on age—but may increase due to inflation and other factors.*
- Attained-Age-Rated Pricing: Premiums are lower for younger buyers but increase with age, inflation, and other factors.*
*Some other factors that could affect pricing include your deductible amounts (if any), discounts, and guaranteed issue rights.
We analyzed available supplement plans by state. To learn more about the most popular plans in your state, visit our plans by State, select your state from the drop-down menu, and click on “Supplement Plans.”
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Or call today to speak with a licensed agent.855-802-1206
Here’s how to get coverage.
Make sure you know the enrollment rules.
Your first chance to enroll is during your open enrollment period. The period begins on the first of the month you turn 65—as long as you enroll in Part B. During open enrollment, insurance companies cannot delay your coverage start date, charge you higher premiums, or deny you a policy due to your health. These protections are called “guaranteed issue rights,” and in situations where these rights apply, federal law allows you to buy any Medigap plan that is sold in your state.
If you don’t enroll during your open enrollment period, you may have to pay more to get a plan and insurance companies can deny you coverage for health conditions.
Below are three examples of open enrollment periods that may apply, depending on your situation.
Example #1: You turn 65 next year on March 9 and plan to sign up for Part B right away.
Your open enrollment period begins March 1 (the month you turn 65)—as long as you enroll in Part B during your Initial Enrollment Period.
Example #2: You turned 65 one month ago and haven’t signed up for Part B.
Your open enrollment period begins the first of the month that you’re enrolled in Part B. Note that your Part B Initial Enrollment Period ends three months after your 65th birthday month. If you miss this period, you’ll pay a penalty—in the form of an increased premium—to sign up later.
Example #3: You didn’t sign up for supplemental insurance during your open enrollment period.
You may be able to apply for a plan outside of open enrollment. But unless you have a guaranteed issue right, insurance companies may ask you to answer health questions and then charge you higher premiums or deny you coverage for existing conditions.
We can help you get coverage from these companies.
Many private insurance companies nationwide sell Supplement Plans. We work with several companies—listed below—to help you find the coverage that’s right for your needs. Each company may not offer all 10 types of plans, but they all offer at least Plan A coverage.