Understanding Medicare Supplemental Insurance – Medigap
Plans A through N
Medicare Supplement Insurance (Medigap) can help you cover costs that Original Medicare Parts A and B do not cover.
(Click on any section title or arrow below to reveal Medicare Supplement Insurance choices in detail – click on the arrow to close)
What is Medicare Supplement Insurance (Medigap)?
Medicare Supplement Insurance (also known as Medigap) pays for expenses that are not covered by Original Medicare (Parts A and B). These plans are offered by private insurance companies.
Original Medicare has “gaps” – deductibles, copayments and coinsurance. Without a Medigap policy you have to to pay for these out-of-pocket expenses when they occur.
A Medigap policy has ten standardized plans (refer to the table below). This means all private insurance companies have to offer the same features of a plan, for example, Plan F or plan G, as the other company. Where they can and do differ, is on the price or premium you have to pay for the Supplement.
LifeSmart, being contracted with all the top insurance carriers, will be able to find you the most affordable Medigap plan.
From the table below, you can see that Plan F will cover most of your out-of-pocket expenses that Original Medicare does not cover, whereas Plan N, for example, does not cover the Medicare Part B deductible and Part B excess charges – you can therefor expect to pay more for a Plan F supplement than a Plan N. However, if you are in good health, the Plan N might make more sense for you.
LifeSmart will give you the best advise, considering your unique circumstances, as to which plan will work best for you.
Enrolling in a Medigap program
- You can purchase a Medigap plan in all 50 states.
- The best time to buy a plan is during the open enrollment period. During this period, you cannot be declined plan coverage due to any health conditions, pre-existing illnesses or medications you are taking.
- After the open enrollment period you can still apply for a Medigap policy – however, you will have to answer some health questions and could be declined by the insurer.
- You must have Original Medicare (Parts A and B) to buy a Medigap policy.
- Medigap policies only cover you – your spouse must have their own individual policy.
- You can cancel your Medigap policy at any time.
- A Medigap policy is guaranteed renewable and cannot be cancelled due to changes in your health.
* In some states, Plan F is also offered as a high deductible plan by some insurance companies. If you choose this option, you will have to pay a deductible of $2,180 (coinsurance, copayments and deductibles) in 2016 before the policy pays anything.
** For Plans K and L, after you meet your out-of-pocket yearly limit and your yearly Part B deductible, the 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 do not result in an inpatient admission.
(Please note that Medicare Supplement insurance works differently in Massachusetts, Wisconsin and Minnesota.)
Remember : Plans A, B, C and D ARE NOT the same as Parts A, B, C and D (refer to Understanding Your Medicare Choices)
View the Medigap plan coverage table on a desktop computer.