Medicare doesn’t cover all of your health care expenses when you turn 65. Medicare Part A covers inpatient care in hospitals and skilled nursing facilities, and Medicare Part B covers outpatient care such as doctor visits and medically necessary supplies.
Medicare A and B typically covers 80% of medical and hospital expenses. For the 20% not covered by Medicare, you can purchase Medicare Supplement (Medigap) insurance from a private insurance company.
If you have questions about Medicare Supplement insurance or are ready to explore the available options, knowledgeable help is just a phone call away. Or, read on to see what Medicare Supplement insurance offers and how to pick the best plan for your needs.
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Medicare Supplement, also known as Medigap, is a private insurance policy purchased to help pay for what isn’t covered by Original Medicare (which includes Part A and Part B). These secondary coverage plans only apply with Original Medicare—not other private insurance policies, standalone Medicare plans or Medicare Advantage plans.
Medigap plans generally don’t cover prescriptions, so you will want to consider enrolling in Medicare Part D to avoid late enrollment penalties, which specifically covers prescription drugs, or a Medicare Advantage plan that includes drug coverage.
Medigap plans aren’t the same as Medicare Part C, also known as Medicare Advantage. While a Medicare Advantage plan can serve as an alternative way to get Medicare Part A and Part B coverage, Medigap plans only cover what Part A and Part B do not.
To be eligible for a Medicare Supplement plan, you must be enrolled in Original Medicare Part A and Part B, but not a Medicare Advantage plan. You must also be in one of the following categories:
Your Medicare Supplement open enrollment period starts the first month you sign up for Medicare Part B insurance at age 65 or older, even if you delayed enrollment because you had group health coverage, and lasts for 6 months.
During this period, you can get a Medicare Supplement policy without any health questions and at the lowest cost offered by the carrier.
Medigap policies cannot be canceled by the insurance company even if your health status changes as long as you pay your premiums. If you’re already enrolled in a Medigap plan, you may apply to buy or switch plans.
To find the right Medigap plan for you, first ask yourself:
CoverRight is a licensed insurance agency that works with top-rated Medicare Supplement carriers nationwide. Their knowledgeable professionals can answer your questions and help you compare Medicare Supplement plans available in your area in minutes.
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Get Answers, Compare Plans & More Knowledgeable Medicare Supplement specialists are ready to help Or Call 866-828-2917 for More InfoThere are 10 standardized Medigap plans with letter names A through N. Plans with the same letter must offer the same basic benefit regardless of the insurance company providing the plan. For example, all Medigap Plan A policies provide the same benefit, but health insurance company premiums vary based on the way they choose to set rates—community-rated, entry age-rated or attained-age-rated.
Medicare Supplement plans F, G and N are the most popular Medigap plans with the highest rates of enrollment nationwide. Which one is best depends on the beneficiary and their specific health care needs.
One of the primary benefits of Medicare Supplement plans is that they help mitigate the costs of health care not covered by Original Medicare, such as copayments, coinsurance and deductibles. Any Medicare beneficiary who’s concerned about incurring potentially high out-of-pocket costs should consider Medigap plans and how they can help cover these expenses.
Some Medicare Supplement plans also provide coverage for services that Original Medicare doesn’t cover, such as medical care needed during travel outside the U.S. Medicare enrollees who enjoy frequent travel often enjoy the additional layer of protection.
Medigap coverage and costs vary by carrier and not every carrier offers all plans. Insurance companies that offer Medicare Supplement plans typically set their premium pricing one of three ways:
Factors that can influence your rates include your location, gender, marital status and lifestyle (like if you smoke).
Medigap policies can be purchased from any insurance company licensed to sell one in your state, but available policies and prices will depend on your state. Medigap plans only cover one person, so married couples need to purchase separate policies.
The best time to enroll in a Medicare Supplement plan is during your initial Medigap Open Enrollment Period. This is the six-month window that begins on the first day of the month in which you’re both 65 or older and enrolled in Medicare Part B. This enrollment period is the only timeframe in which insurance companies cannot deny you a policy based on your health status or any medical condition.
Attempting to enroll in a Medicare Supplement plan at any other time outside this enrollment period could result in penalty fees or denial of coverage.
You can research Medigap plans on your own by visiting Medicare.gov to get a list of providers in your area. However, it can be far easier to work with knowledgeable professionals who search the Medigap market on your behalf and help narrow down plans and providers that met your unique needs.
You should consider enrolling in a standalone Part D Prescription Drug plan to avoid late enrollment penalties.
Navigating Medicare A and B, Medigap and Medicare Advantage requirements and restrictions can be confusing, but there are people ready to help you make the best decision based on your needs.
Forbes has teamed up with CoverRight to simplify the process of comparing and purchasing Medicare Supplement plans nationwide. Simply call and answer a few questions about the state you live in and your health care needs to get started. CoverRight’s licensed agents are standing by, ready to help.
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