Knowing the best Medicare supplement insurance plan is essential when choosing your health insurance plan
Today, most people choose to buy Medicare supplement insurance plans from a private insurer to cover the gaps in Medicare. Of course, you may be hesitant to spend more money on other plans. Is a Medigap policy worth it? Is a Medigap policy right for you? – To make the right decision, you must first learn about this plan, understand the benefits, and determine your budget. So what is the best Medicare supplement insurance plan? Let us begin!
Is the Medicare supplement plan the same as Medigap?
The terms Medicare supplement plan and Medigap are used interchangeably because they are both used for the same health insurance plan. Any company or facility certified by Medicare uses both terms to refer to this plan. The term “Medigap” is used more often because it is a bit shorter. So what is the explanation of the names? – Medigap is the plan that fills the “gaps” that Original Medicare doesn’t cover. As for the Medicare Supplement, it is the plan that “supplements” Original Medicare and covers Medicare out-of-pocket costs. No need to get confused!
First, what are Medicare supplemental benefits?
As we said before, Medicare supplement plans pay for out-of-pocket costs not covered by Medicare A and B. Yes, Original Medicare has extensive coverage, but not all health care services and supplies. Here comes the role of the Medicare supplement plan that covers the remaining costs, including copays, deductibles, and coinsurance. The best thing about this plan is that it covers medical services when you travel outside of the US, unlike Original Medicare. However, it does not cover prescriptions. You must join a separate Medicare Part D prescription drug plan.
In most states, there are 10 basic Medigap plans, which are benefits A, B, C, D, F, G, K, L, M, and N. Be sure to differentiate between Medicare Part A and the Medigap Plan. A. Plans E, H, I and J are no longer available to subscribe to. You should choose a reputable health insurer and ask for different prices before making a purchase.
Things to know about Medigap policies:
- You must have Original Medicare (Parts A and B)
- Medigap only supplements what the Original Medicare benefits do not cover
- Medigap is not a plan to get Medicare benefits.
- The Medigap plan covers only one person. If you and your spouse need this coverage, you will need to purchase two separate policies.
- You can get this plan from any licensed insurance company in your state or area.
- As long as you pay the premium, the insurance company cannot cancel your plan.
- The insurance company cannot sell you a Medigap plan if you have a Medicare Advantage plan. Legal only if you go back to Original Medicare
Benefits that may be covered by some Medicare supplement insurance plans
All Medicare supplement plans offer basic health care benefits, including:
Part A and B deductibles
Covers a combination of Part A and Part B deductibles, including excess Part B charges, foreign travel emergencies, and Part A SNF (Skilled Nursing Facility) coinsurance.
Part A hospital coinsurance
Covers 100% of Medicare Part A hospital coinsurance with the addition of an additional 365 days after Medicare benefits are exhausted.
Part A hospice coinsurance
Covers 100% of Medicare Part A hospice coinsurance. However, plan K covers only 50% and plan L covers only 75% of hospice coinsurance.
First 3 pints of blood
Covers 100% of the first three pints of blood each year. However, plan K covers only 50% and plan L covers only 75%.
Part B Coinsurance
Covers 100% of Medicare Part B coinsurance or copayments. However, plan K covers only 50% and plan L covers only 75%.
Medigap policies do not cover the following:
- long term care
- vision care
- Dental care
- Earphones
- Long-term care (outside the US)
- Glasses
- private nursing
- Part A and B deductibles
- Medicare Part B copays and coinsurance
- Prescription drugs
What are the different Medicare supplement plans?
Many private health care insurers offer 10 different supplemental plans which are A, B, C, D, F, G, K, L, M and N. Here is a comparison between the plans, presenting the basic benefits of each policy:
Medigap Plan A coverage
- Covers Part A coinsurance and hospital expenses with an additional 365 days after Medicare benefits run out.
- Covers Part B coinsurance or copayment
- Covers blood (first 3 pints)
- Covers Part A hospice coinsurance or copayment
- Does not cover Part A deductible
- Does not cover Part B deductible
- Does not cover excess Part B charge
- It does not cover the exchange of trips abroad.
- No out-of-pocket limit
Medigap Plan B coverage
- Covers Part A coinsurance and hospital expenses with an additional 365 days after Medicare benefits run out.
- Covers Part B coinsurance or copayment
- Covers blood (first 3 pints)
- Covers Part A hospice coinsurance or copayment
- Covers the Part A deductible
- Does not cover Part B deductible
- Does not cover excess Part B charge
- It does not cover the exchange of trips abroad.
- No out-of-pocket limit
Medigap Plan C coverage
- Covers Part A coinsurance and hospital expenses with an additional 365 days after Medicare benefits run out.
- Covers Part B coinsurance or copayment
- Covers blood (first 3 pints)
- Covers Part A hospice coinsurance or copayment
- Covers coinsurance for skilled nursing facility care.
- Covers the Part A deductible
- Covers the Part B deductible
- Does not cover excess Part B charge
- Covers 80% of foreign travel exchange.
- No out-of-pocket limit
Medigap Plan D coverage
- Covers Part A coinsurance and hospital expenses with an additional 365 days after Medicare benefits run out.
- Covers Part B coinsurance or copayment
- Covers blood (first 3 pints)
- Covers Part A hospice coinsurance or copayment
- Covers coinsurance for skilled nursing facility care.
- Covers the Part A deductible
- Does not cover Part B deductible
- Does not cover excess Part B charge
- Covers 80% of foreign travel exchange.
- No out-of-pocket limit
