Medicare Supplement (Medigap)

Medicare Supplement Plans (Medigap)

Once enrolled in Medicare parts A and B you will want to choose one of two supplemental insurance avenues:

(Avenue 1) Medicare Supplement and Part D Rx Plan, or (Avenue 2) Medicare Advantage

This page explains the details of Medicare Supplement (also called Medigap) plans.

Medicare Supplement plans are quite simply insurance policies offered by private insurance companies.  These insurance policies are designed to pay part or all of the “gaps” in Medicare coverage (i.e, what Medicare Parts A and B do not pay at the hospital, doctor’s office or other providers).  I like to say that Medicare Supplement plans “dovetail” with Medicare, filling in right where Medicare leaves off, to pay the deductibles, daily amounts, and coinsurance you would pay if you did not choose any supplemental insurance.

There are certain features all Medicare Supplement plans offer, no matter which plan or insurance company you choose:

-All Medicare Supplement plans use the same network of providers, the Medicare network

If a doctor, hospital, or provider accepts Medicare then you automatically know they accept your Medicare Supplement insurance. That is because Federal law mandates that any insurance company offering Medicare Supplement plans adopt Medicare as their “network.”

-You can use the Medigap coverage in all 50 states, not just your state

There are Medicare providers in all 50 states, and you can visit any type of Medicare provider any time you please, anywhere, anytime. So you never need to feel like your Medicare Supplement coverage forces you to visit doctors just in your town. Medicare Supplement insurance travels with you!

-Medicare Supplement plans are easy to enroll in, and easy to keep

Medicare Supplement plans are easy to enroll in. There are no physical exams or medical records to send in.

And in most instances, including when you are enrolling in coverage on or near your 65th birthday, or enrolling after age 65 because your employer-sponsored health insurance is ending, Medicare Supplement plans are “guaranteed issue.” Guaranteed issue means you will be approved for coverage, because the insurer cannot base your enrollment on your health history. 

And Medicare Supplement plans are easy to keep. The insurer that offers your Medigap plan cannot cancel the coverage because your health history has changed or you have incurred many claims. The only reason the insurer can cancel the Medicare Supplement plan is for non-payment of your monthly premium costs.

 

-Medicare Supplement plans are “standardized,” + easy to compare

The Federal Government (Medicare), not insurance companies,  designed Medicare Supplement insurance plans, and what they cover. Any insurance company that wants to offer a Medicare Supplement insurance plan has to design their plan just as mandated. No exceptions.

This means it is easier to compare benefits, and compare costs. If you are looking at “Plan G” for example, and compare plans from two or more insurance companies, you know the benefits of the plan and the network of providers you can visit are identical.

So you can compare the price of the monthly premium cost, consider the financial strength of the insurer, and the insurance company’s reputation for customer service to make your decision. You do not have to get bogged down in benefit differences.

Medicare Supplement Plan Designs

This chart is a helpful visual in helping you see how the plans are standardized, regardless of the insurance company you choose. It also shows how the medical expenses Medicare leaves for you to pay are picked up and covered by the differing plan designs.

 

We can walk you through how the benefits work in a more conversational way, so you can understand what is covered, and what medical costs you might be responsible for, before you choose the plan design that fits you best.

When Reviewing Medigap Plan Designs, Note Plan G

We recommend Medicare Supplement Plan G a majority of the time. Here is why:

 

Plan G is the most benefit-rich plan

Plan G pays all of the out of pocket medical costs Medicare Parts A and B leave for you to pay with only one exception, the $233 Medicare Part B deductible you would incur at a doctor’s office visit With Plan G you know that your out of pocket maximum when visiting hospitals, doctor’s offices, surgical centers, urgent care & emergency rooms is $233. For the entire calendar year. (Prescriptions from a pharmacy are not covered here)

Plan G is usually the most cost-efficient plan cost-wise

Insurers set their monthly costs based on a number of factors, such as benefits, claims history, and administrative costs. But they also want to be competitive, as many people turn 65 and enter eligibility each day. Insurers, really wanting to sell you a plan, try to be as competitively priced as possible, and over time, the most pricing pressure is placed on the most popular plans. Over the last few years, as Plan G has become the most chosen plan, rates have dipped, while other plan designs have not received the same pricing pressure.

So when you review many insurance companies’ current rates for Medigap plans, the monthly cost of Plan G will be less than other plan designs (such as Plan A) that offer fewer benefits!

 

A Few of the Medicare Supplement Insurance Providers We Work With

Free Info Packet and Quotes

Note: Privacy is something we take seriously, and keeping the information you shared private is of utmost importance to us.  We do not share any information with third parties.  The minimum of information is shared with an insurance company to put together a detailed free quote and illustration for you.