What is Medicare Supplement?

Also known as Medigap insurance, Medicare Supplement insurance helps pay for costs that Original Medicare (Part A and Part B) doesn’t cover. For example, Original Medicare may not cover certain deductibles or copays; or pay for routine dental, vision, and hearing checks. If you need eyeglasses or hearing aids, those are considered out-of-pocket expenses. If you need prescription medication coverage, then you’ll need to enroll in Medicare Part D Prescription Drug Plan.

There are ten Medigap insurance plans available in most states, and each plan type is designated by one of the following letters: C, D, F, F (High deductible), G, G (High deductible), K L, M, or N. The kind of coverage is standardized across each plan letter, so no matter which private insurance company you select, you will be getting the same basic benefits for Medicare Supplement coverage within the same letter. However, even if standardized benefits are the same across plans of the same letter category, premium costs may vary by the insurance company and/or location. If you live in Massachusetts, Minnesota, or Wisconsin, your Medicare Supplement plans may look different due to state-specific standards.

Medicare Supplement insurance plans do not provide stand-alone coverage, so patients will still have to be enrolled in Original Medicare, Part A, and Part B, for hospital and medical coverage.

Let’s Take a Closer Look at Medicare Supplement Choices:

Medigap Plan C

Premiums range from $158-$596, depending on your age, sex, health status, and when you buy. (Doesn’t include $148.50 Standard Part B premium.)

Plan Benefits include:

Skilled nursing facility 

Part A deductible 

Part B deductible 

Foreign travel emergency 

Medigap Plan D

Premiums range from $124-$492, depending on your age, sex, health status, and when you buy. (Doesn’t include $148.50 Standard Part B premium.)

Plan Benefits include:

Skilled nursing facility 

Part A deductible 

Foreign travel emergency

Medigap Plan F

Premiums range from $146-$1,148 depending on your age, sex, health status, and when you buy. (Doesn’t include $148.50 Standard Part B premium.)

Plan Benefits include:

Skilled nursing facility 

Part A deductible

Part B deductible 

Part B excess charges

Foreign travel emergency

 

Medigap Plan F (High Deductible)

Premiums range from $40-$168 depending on your age, sex, health status, and when you buy. (Doesn’t include $148.50 Standard Part B premium.)

Plan Benefits include:

Skilled nursing facility 

Part A deductible

Part B deductible 

Part B excess charges

Foreign travel emergency

Medigap Plan G

Premiums range from $116-$1,038 depending on your age, sex, health status, and when you buy. (Doesn’t include $148.50 Standard Part B premium.)

Plan Benefits include:

Skilled nursing facility 

Part A deductible

Part B excess charges

Foreign travel emergency

Medigap Plan G (High Deductible)

Premiums range from $30-$174 depending on your age, sex, health status, and when you buy. (Doesn’t include $148.50 Standard Part B premium.)

Plan Benefits include:

Skilled nursing facility 

Part A deductible

Part B excess charges

Foreign travel emergency

Medigap Plan K

Premiums range from $45-$242 depending on your age, sex, health status, and when you buy. (Doesn’t include $148.50 Standard Part B premium.)

Plan Benefits include:

Skilled nursing facility 

Part A deductible

Medigap Plan L

Premiums range from $81-$353 depending on your age, sex, health status, and when you buy. (Doesn’t include $148.50 Standard Part B premium.)

Plan Benefits include:

Skilled nursing facility 

Part A deductible

Medigap Plan M

Premiums range from $149-$432 depending on your age, sex, health status, and when you buy. (Doesn’t include $148.50 Standard Part B premium.)

Plan Benefits include:

Skilled nursing facility 

Part A deductible

Foreign travel emergency

Medigap Plan N

Premiums range from $93-$807 depending on your age, sex, health status, and when you buy. (Doesn’t include $148.50 Standard Part B premium.)

Plan Benefits include:

Skilled nursing facility 

Part A deductible

Foreign travel emergency

For details on copays, coinsurance, deductibles and more accurate premium details in your state click here.

What is Medicare Advantage?

Medicare Advantage Plans, also known as Part C, are offered by private insurance companies that are Medicare-certified. These private insurers may offer different options within their Medicare Advantage plans, so you’ll need to carefully review each plan to ensure you are getting the coverage that you need. Subtle differences can bring unexpected out-of-pocket costs and making any changes in your coverage will have to wait until the next open enrollment period.

Many Medicare Advantage Plans include Medicare Part D prescription drug coverage. Also known as Medicare Advantage Prescription Drug plans, these options give you the convenience of having all of your Medicare benefits administered through a single plan. With your low, or no-cost plan premium you may be required to pay a small co-pay or co-insurance when receiving certain health care services.

All Medicare Advantage Plans are required, by the federal government, to cover everything that Original Medicare covers, and some plans cover exams and extras that Original Medicare does not; including eyeglasses, hearing aids, wheelchair ramps, no-slip shower grips, meal delivery services, and transportation to and from doctors’ appointments. In some cases, Medicare Advantage even offers wellness plans to keep seniors active, healthy, and independent. Here are some of the best according to a 2021 U.S. News & World Report:

https://health.usnews.com/health-news/best-medicare-plans/best-insurance-companies-for-medicare-advantage-plans

Medical Supplement Insurance vs Medicare Advantage Plans: How Do I Choose?

Both Medicare Supplement Insurance Plans and Medicare Advantage Plans are offered by private insurance companies approved by Medicare, so how do you know which plan is right for you? Let’s look at a few differences that may help:

  • Medicare Supplement Plans are accepted by any medical provider or hospital that accepts Medicare, while Medicare Advantage Plans require that you select in-network providers. 
  • With Medicare Supplement Plans, seeing a specialist does not require a referral. With Medicare Advantage coverage, you may be required to get a referral to see an in-network specialist.
  • With Medicare Advantage Plans you may encounter network restrictions while traveling, while Medicare Supplement coverage allows you to travel worry-free.
  • Enrollment in Medicare Supplement Plans can happen any time after turning 65. With Medicare Advantage Plans, enrollment is restricted to two open enrollment periods per year.
  • With Medicare Advantage, prescription drug coverage is included. With Medicare Supplement you will need to purchase separate coverage. (Medicare Part D.)

Start Early and do Your Research!

Choosing the right healthcare coverage is very personal as we all have unique health, wellness, and financial needs. It’s important to take time to consider both your Medicare Supplement insurance and Medicare Advantage plan options, to find the coverage that works best for you.