No one plan fits all. Not all plans or carriers are the right choice. We help the client choose the right plan.
Also known as Medigap coverage, Medicare Supplement Insurance is secondary coverage to Original Medicare’s primary coverage. These policies help pay your share of Medicare expenses, such as your deductibles and co-insurance. How much is covered depends on the plan chosen.
Medicare Supplement Plans are offered by private health insurance companies. Every private health insurance company offers different plans. Because Centers for Medicare and Medicaid Service (CMS) mandates standardized coverage, every health plan that offers the same plan letter gives exactly the same coverage (please refer to the chart below). However, the price for the same coverage varies among different insurers.
People new to Original Medicare are surprised by the fact that it only covers 80% of Part B expenses. The other 20% is out of pocket with no out of pocket maximum. This could be devastating financially if you become seriously ill or injured. There is also a deductible associated with both Part A and Part B. Medicare Supplement plans pay for these out of pocket expenses which gives peace of mind by eliminating most or all of the cost-share responsibility
What is Medicare Supplemental Insurance (aka Medigap Insurance)?
- It came into being shortly after Original Medicare was signed into law in 1965.
- It is a secondary payor with Original Medicare being the primary payor of your medical cost.
- It does not include a prescription drug plan. Need to purchase a Part D prescription plan
- Typically does not cover routine dental, vision, and hearing services. There are plans available to buy up for these services.
- There are 10 plans available to choose from.
- Accepted everywhere Original Medicare is accepted.
What Are The Different Medicare Supplement Plans?
Each of the 10 Medicare Supplement Plans is represented by the letters A through N. Each letter represents a different coverage. Some plans are more popular than others. Below is a chart to summarize the coverage for the different plans.
|Medicare Supplement Benefits||Medicare
|Part A coinsurance and hospital costs up to an additional 365 days after Medicare
benefits are used up
|Part B coinsurance or copayment||Yes||Yes||Yes||Yes||Yes||Yes||50%||75%||Yes||Yes***|
|Blood (first 3 pints)||Yes||Yes||Yes||Yes||Yes||Yes||50%||75%||Yes||Yes|
|Part A hospice care coinsurance or copayment||Yes||Yes||Yes||Yes||Yes||Yes||50%||75%||Yes||Yes|
|Skilled nursing facility care coinsurance||No||No||Yes||Yes||Yes||Yes||50%||75%||Yes||Yes|
|Part A deductible||No||Yes||Yes||Yes||Yes||Yes||50%||75%||50%||Yes|
|Part B deductible||No||No||Yes||No||Yes||No||No||No||No||No|
|Part B excess charge||No||No||No||No||Yes||Yes||No||No||No||No|
|Foreign travel exchange (up to plan limits)||No||No||80%||80%||80%||80%||No||No||80%||80%|
|Out-of-pocket limit **||N/A||N/A||N/A||N/A||N/A||N/A||$5,560||$$2,780||N/A||N/A|
* Plan F also offers a high-deductible plan. If you choose this option, this means you must pay for Medicare-covered costs up to the deductible amount of $2,300 before your Medigap plan pays anything.
** After you meet your out-of-pocket yearly limit and your yearly Part B deductible, the Medigap plan pays 100% of covered services for the rest of the calendar year.
*** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don't result in inpatient admission.
Starting January 1, 2020, Medigap plans sold to new people with Medicare won’t be allowed to cover the Part B deductible. Because of this, Plans C and F will no longer be available to people new to Medicare starting on January 1, 2020. If you already have either of these 2 plans (or the high deductible version of Plan F) or are covered by one of these plans before January 1, 2020, you’ll be able to keep your plan. If you were eligible for Medicare before January 1, 2020, but not yet enrolled, you may be able to buy one of these plans.
How Medicare Supplement Plans Work
In order to enroll in a Medicare supplement plan, you must first enroll in Original Medicare Parts A and B. When enrollment is completed and you are issued an Original Medicare ID number with Parts A and B effective dates you can then enroll. Typically plans are underwritten to determine if you are healthy enough to enroll. However there are certain Guaranteed Enrollment Periods where your application will not be medically underwritten. The most common guaranteed period is the month you turn 65 up to six months after. There are other Guaranteed Issue periods. As Medicare brokers/consultants we can help you identify which one could work for you.
Finding the right Medicare Supplement Plan that meets your needs and your budget can be complicated. Don’t hesitate to contact our agency for information and quotes for Medicare Supplement for companies in your area. Call 562-343-7301 or chat with us online for help.
2725 E Pacific Coast Hwy.
Signal Hill, CA 90755