Medicare supplement plans are called Medigap plans. They help fill in the gaps in coverage of a regular Medicare plan. Medicare supplement plans help pay for deductibles, coinsurance, and copayments among other things. In 47 states, there are 10 standardized Medigap plans that are denoted by the letters A through N. The private insurance companies offering these plans usually do not offer every Medigap plan. However, if they choose to offer supplemental coverage, they must offer Plan A and Plan C or F. Medicare Supplement plans do not cover vision, dental, long-term care, or hearing aids.
Medicare Supplement Plan Coverage
Medicare Supplement plans each offer different levels of coverage, but each lettered plan must include the same standardized benefits regardless of carrier and location. Most plans do cover these basic benefits:
Medicare Part A coinsurance costs up to an additional 365 days after original Medicare benefits are exhausted
Medicare Part A hospice care coinsurance or copayments
Medicare part B coinsurance or copayments
First three pints of blood used in a medical procedure
Plans that include additional coverage, such as Plan F, may also offer a variation of the following additional benefits:
Medicare Part A deductible
Medicare Part B deductible
Part B excess charges
Skilled Nursing Facility (SNF) care coinsurance
Foreign travel emergency care
Typically Plan F is the most comprehensive out of all the Medigap policies. Although it does not cover everything, it does offer pretty extensive coverage. Depending on the carrier, there may be additional costs associated with Plan F. Plan F’s expansive coverage makes it a popular plan because it often leaves the beneficiary with little to no out of pocket expenses. Many times it will cover all remaining hospital and doctor costs after the original Medicare Part A and/or B has paid its portion. Additionally there is a high deductible Plan F option. It requires beneficiaries to pay a certain amount of out of pocket charges before it kicks in and starts paying for coverage. The coverages are still the same under this alternative Plan F, but the monthly premiums are typically more affordable for those requiring regular medical attention.
Plan G is very similar to Plan F. The biggest difference in the two plans is that Plan G requires the beneficiary to pay the Medicare Part B deductible out of pocket. Medicare Plan G was designed to help beneficiaries cover excess costs from healthcare providers. The majority of Medigap Plans available do not cover Part B excess charges. Excess charges are defined as additional expenses incurred outside of the Medicare approved charge. This is why Plan G is particularly popular with those who have frequent medical needs.
Medicare Supplement Plan Costs
For the most part, private insurance companies are required to offer the same benefits for each lettered plan. However, they do have the option to charge higher out of pocket costs for this coverage. It is recommended that beneficiaries shop around to find a Medicare Supplement Plan that fits both their medical and financial needs. Out of pocket costs associated with Medicare Supplement plans may include monthly premiums and yearly deductibles. Plans may price their premiums in the following ways:
Community no-age-rated: These plans require premiums that are the same across the board, regardless of age.
Issue-age-rated: The plans base their premiums on the age of the beneficiary at the time of enrollment. The younger a person is when they enroll in this type of plan, the lower the premiums will be.
Attained-age-rated: Like issue-age-rated, these plans base their premiums on the age of the beneficiary at the time of enrollment, but unlike the other, the premiums increase with age. As the beneficiaries get older, the premiums go up.
Medicare Supplement Plan Enrollment and Eligibility
In order to be eligible to enroll in a Medicare Supplement Plan, one must already be enrolled in both Medicare Part A and Part B. The absolute best time to enroll in a plan is during the Medigap Open Enrollment Period. This period begins on the first day that one is both age 65 or older and enrolled in Medicare Part B, but it only lasts for six months. During this period, you have the guaranteed issue right to join any plan of your choice. This means that you may not be denied coverage based on any pre-existing conditions. If you miss this enrollment period and attempt to enroll in the future, you may be denied coverage based on your medical history. If you apply for your Medigap coverage during open enrollment and you have health problems, you will be able to purchase your policy for the same price as those with good health.
Whether you are enrolling in Medicare or shopping for Medigap coverage, it pays to do your homework beforehand. The rules of each state differ, as do the policies within each company. Depending on you medical history and future need for care, you can find a Medigap policy to fit your needs and your budget. Most states have a State Health Insurance Assistance Program that is available to help those shopping for Medigap coverage. This is a good place to start your research.