Medigap Plans
What is a Medigap Plan?
Medicare pays for a lot of senior healthcare expenses, but not everything. There are deductibles and coverage limits than can really add up to huge bills in the event of a catastrophic event. A Medicare supplement policy, commonly referred to as a Medigap plan, can help cover those costs and protect you in the event of a catastrophic illness, and even provide protection beyond what Medicare covers, such as when you travel abroad. Original Medicare will pay its share for covered medical costs, and then the supplement will step in and pay its share of whatever is left. Depending on the specific Medigap plan you choose, your final out of pocket expense can potentially be as low as $0, or very close to it.
What Types of Plans Are Available?
Medigap plans are offered by different private insurers with different underwriting standards and premiums, but plan benefits are standardized by alphabetical letter in most states. For example, all Plan A policies will cover the first three pints of blood, which is not covered by Medicare, no matter which insurer you have your policy through. To understand the different levels of benefits, it’s helpful to view them in a chart.
| Medigap Plan | A | B | C* | D | F* | G | K | L | M | N |
| Part A Coinsurance + 365 additional hospital days | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ |
| Part B Coinsurance | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | 50% | 75% | ✔ | ✔** |
| First 3 Pints of Blood | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | 50% | 75% | ✔ | ✔ |
| Hospice Care Conisurance | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | 50% | 75% | ✔ | ✔ |
| Skilled Nursing Facility Coinsurance | ✔ | ✔ | ✔ | ✔ | 50% | 75% | ✔ | ✔ | ||
| Medicare Part A Deductible | ✔ | ✔ | ✔ | ✔ | ✔ | 50% | 75% | ✔ | ✔ | |
| Medicare Part B Deductible | ✔ | ✔ | ||||||||
| Part B Excess Charges | ✔ | ✔ | ||||||||
| Foreign Travel Emergency | ✔ | ✔ | ||||||||
| Out-of-Pocket Limit | $4800 | $2400 |
**Plan N pays Part B coinsurance except for a $20 copay for office visits and a $50 copay for emergency room visits that do not result in admission.
How Do I Choose?
In order to qualify for a Medigap plan, you must currently be enrolled in both Medicare Part A and Part B. Once enrolled in a plan, you will pay a monthly premium for your supplement, in addition to your regular Part B premium. Different carriers have different underwriting requirements and policies, so it’s critical that you have an experienced agent with access to the best quoting engines shop it for you. You might see some online “instant quote” engines, but these are inaccurate, misleading, and unreliable because they don’t take factors like premium increase history and underwriting into consideration. A cheap premium on a quote doesn’t do you any good if that particular company disqualifies applicants for some specific health condition that you have. An experienced agent will know all the different underwriting criteria and help you avoid wasting time and/or money with the wrong companies. Some companies also may have a history of large or unpredictable premium increases in certain areas, and your agent can help you avoid these future costs, as well.
If you are not currently enrolled in a Medigap plan, we can help you choose the right one to meet your needs. And if you are enrolled in one already, let our experts shop it for you to be sure that you’re saving the most money possible. There’s no downside to checking.
Contact us today for a free consultation. There is never any cost or obligation to review your options with us, and getting quotes will not affect your existing plan unless you choose to enroll in a new plan.
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