Haris Ashley
Medicare Supplement Insurance, also known as Medigap, is extra insurance that you can purchase from a private health insurance company to help cover out-of-pocket costs not covered by Original Medicare (Part A and Part B). When considering where to purchase a Medigap policy, it's important to remember that these policies are offered by various insurance companies licensed to sell them in your state. You can compare the benefits of each lettered plan, select the one that meets your needs, and then find insurance companies selling that specific plan. Price is the main differentiating factor between policies with identical letters offered by different companies, so it's recommended to contact multiple companies for estimates. Additionally, you can seek free assistance from your local State Health Insurance Assistance Program (SHIP) to make an informed choice.
| Characteristics | Values |
|---|---|
| What is Medicare Supplement Insurance (Medigap)? | Extra insurance to help pay your share of out-of-pocket costs in Original Medicare. |
| Who can buy it? | Generally, you must have Original Medicare – Part A (Hospital Insurance) and Part B (Medical Insurance) – to buy a Medigap policy. |
| Where can you buy it? | You can buy a Medigap policy from any insurance company that's licensed in your state to sell one. |
| When to buy it? | Your best time to buy a policy is during the Medigap Open Enrollment Period. |
| How to buy it? | Compare the benefits of each lettered plan and select the plan that meets your needs. |
| How much does it cost? | The benefits in each lettered plan are the same, but prices vary between companies, so contact more than one company to get an estimate. |
| What to watch out for? | Every Medigap policy must follow federal and state laws, so be aware of illegal practices by insurance companies. |
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What You'll Learn
Compare the benefits of each lettered plan
Medicare Supplement Insurance, also known as Medigap, is an extra insurance policy that you can purchase from a private company to help cover the costs that Original Medicare does not. Medigap policies generally do not cover long-term care, vision, dental, hearing aids, private nursing, or prescription drugs.
There are 10 standard Medigap plan types, labelled from Plan A to Plan N. Each plan offers the same Medicare benefits, differing only in cost and coverage.
Plan A offers Basic Benefits, while Plan B covers the same Basic Benefits as well as the Medicare Part A deductible. Plans A and B generally have higher out-of-pocket costs for things like Skilled Nursing Facility Coinsurance, Medicare Part B Excess Charges, and Foreign Travel Emergency Care.
Plans C, F, and G offer the most supplemental coverage, paying for many of your out-of-pocket costs for Medicare-approved services. These plans are more costly, with higher monthly premiums. Plans C and F are only available to those who were eligible for Medicare before 2020. Plan G offers a high-deductible plan in some states.
Plans K and L specify how much they will pay for approved services before you meet your out-of-pocket yearly limit and Part B deductible. 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 inpatient admission.
The best Medicare Supplement plan for you will depend on your individual needs, financial situation, and health and potential healthcare needs.
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Consider current and future health needs
When considering current and future health needs, it is important to understand the different parts of Medicare and what they cover.
Part A (Hospital Insurance) covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
Part B (Medical Insurance) covers medical care received from doctors and other healthcare providers, outpatient care, medical equipment, and certain drugs administered in a physician's office or outpatient facility.
Part C, also known as Medicare Advantage, is offered by Medicare-approved private companies and provides all the benefits of Part A and Part B. Many Medicare Advantage Plans also include Part D (drug coverage) and additional benefits like dental, vision, and hearing.
When considering current and future health needs, it is important to evaluate which parts of Medicare are most relevant to your situation. For example, if you anticipate needing hospital stays or skilled nursing care, ensuring you have adequate Part A coverage is crucial. On the other hand, if you require regular medical care, outpatient treatments, or prescription drugs, Part B and Part D coverage become more pertinent.
Additionally, considering future health needs may involve anticipating potential changes in your health status. Medicare Advantage Plans offer comprehensive coverage and can provide peace of mind for those who want to prepare for a range of health scenarios. These plans often include benefits beyond original Medicare, such as dental, vision, and hearing coverage, which may become increasingly important as your health needs evolve.
It is also worth noting that some individuals may have specific health conditions or requirements that their Medicare plan needs to accommodate. For instance, Chronic Special Needs Plans (C-SNPs) are tailored for individuals living with qualifying chronic conditions, ensuring their unique health needs are addressed.
When selecting a Medicare plan, it is essential to carefully review the benefits offered and consider how well they align with your current and anticipated future health needs. This proactive approach can help ensure that you have the necessary coverage in place to support your overall health and well-being.
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Shop by price
When shopping for Medicare Supplement Insurance (also known as Medigap), it's important to keep in mind that prices can vary significantly between different insurance companies offering the same lettered plan. This variation in pricing is due to each insurance company's discretion in setting premiums for their Medigap policies. Therefore, it's in your best interest to compare prices for the same lettered plan across different insurance providers. For example, if you're considering Plan G, be sure to compare the pricing for Plan G across multiple companies. This way, you can make an informed decision and choose the most cost-effective option for your needs.
To start your price comparison, you can contact multiple insurance companies that sell Medigap policies in your state to obtain estimates. It is worth noting that the availability of plans can differ between states, and even if a plan is offered in your state, not all insurance companies may sell policies for it. This underscores the importance of comparing prices, as you want to ensure you're getting the best value for your specific situation.
Additionally, you can leverage resources like your local State Health Insurance Assistance Program (SHIP). SHIPs are state-run programs that offer free health insurance counselling to individuals with Medicare and their families. They may have a "Medigap rate comparison shopping guide" for your state, which can provide valuable insights into the pricing landscape. Contacting your State Insurance Department is another step you can take to ensure you're making a well-informed decision. They can inform you if there have been any complaints lodged against the insurance companies you're considering, which could influence your choice.
Once you've gathered estimates and consulted available resources, you'll be in a better position to make a decision. Remember, the insurance company must provide you with a clear summary of your chosen Medigap policy before you finalise your purchase. This summary should outline the specifics of your selected plan, including any exclusions or limitations. By following these steps and shopping by price, you can navigate the Medicare Supplement Insurance landscape effectively and make a choice that aligns with your budgetary needs.
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Contact your local State Health Insurance Assistance Program (SHIP)
If you're looking to pick supplemental Medicare insurance, your local State Health Insurance Assistance Program (SHIP) can be a great place to start. SHIP is a free service that provides unbiased help to Medicare beneficiaries, their families, and caregivers. They can assist you in understanding your options for supplemental coverage, such as Medicare Supplement Insurance (Medigap) plans. Here's why and how you should contact your local SHIP:
Unbiased and Personalized Assistance
SHIP offers one-on-one insurance counselling and assistance with Medicare. Their highly trained volunteers provide personalized guidance to help you navigate the complex world of Medicare and make informed decisions about your coverage options. This includes helping you understand and compare Medigap plans offered by private companies to supplement your Original Medicare (Part A and Part B) coverage.
Information on a Range of Medicare Options
SHIP counselors can educate you about various Medicare options, including Part D, Supplement (Medigap), Medicare Advantage, and Long-Term Care Insurance policies. They can explain the differences between Original Medicare and Medicare Advantage, and help you evaluate which plan best suits your needs. Additionally, they can refer you to appropriate agencies for further assistance with specific needs.
Support with Applications and Cost-Saving Programs
SHIP assists beneficiaries in applying for programs that can help reduce healthcare costs, such as Medicaid, the Medicare Savings Program, and Extra Help/Low Income Subsidy. They provide information on cost-saving measures and inform consumers of their rights as Medicare beneficiaries or health insurance policyholders. This includes helping with applications for assistance programs that cover costs not fully paid by Medicare.
Community Outreach and Education
SHIP conducts outreach through presentations, information distribution, enrollment events, and participation in community events. They strive to educate groups and individuals about Medicare benefits, coverage rules, appeal rights, and more. This proactive approach ensures that SHIP reaches a wide audience and empowers people to make informed choices about their healthcare coverage.
How to Contact Your Local SHIP
To find your local SHIP, you can search for your "state name" followed by "State Health Insurance Assistance Program" or "SHIP." For example, searching for "Indiana State Health Insurance Assistance Program" or "Indiana SHIP" will lead you to the relevant website and contact information. From there, you can explore their website, call their office, or even sign up for their newsletter to stay informed about Medicare-related updates. Remember, SHIP is a free service, and their volunteer counselors are trained to provide confidential and objective assistance.
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Understand federal and state laws
When considering Medicare Supplement Insurance, also known as Medigap, it's important to understand the federal and state laws that govern these policies. Medigap policies are regulated by both federal and state laws, which are designed to protect consumers. Here are some key points to keep in mind:
In the United States, Medigap policies are standardized, which means policies with the same letter offer the same basic benefits regardless of the insurance company or the state in which you reside. There are ten types of Medigap plans offered in most states, labelled A-D, F, G, and K-N. The price is the sole distinction between plans with identical letters offered by different insurance providers. However, it is important to note that in Massachusetts, Minnesota, and Wisconsin, Medigap policies are standardized differently, and these policies must adhere to specific federal and state laws.
During your “Medigap Open Enrollment" period, which lasts for six months from the time you first enrol in Medicare Part B at the age of 65 or older, you have the right to enrol in any Medigap policy without being denied coverage due to pre-existing health conditions. This open enrolment period is a one-time opportunity, so it is important to take advantage of it while you can. After this period, you may face challenges in purchasing a Medigap policy, or the cost may increase.
Medigap policies are required to clearly identify themselves as "Medicare Supplement Insurance" on the policy document. This is an important distinction to look for when comparing policies. Additionally, it is advisable to compare policies from different providers, as costs can vary.
To learn more about your specific state's laws and regulations regarding Medigap, you can contact your State Health Insurance Assistance Program (SHIP) and your State Insurance Department. These programs can provide free and personalised health insurance counselling, ensuring you understand your rights and options under federal and state laws.
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Frequently asked questions
You can buy a Medigap policy from any insurance company that's licensed in your state to sell one.
The best time to buy a policy is during the Medigap Open Enrollment Period.
Before buying a Medigap policy, you should compare the benefits of each lettered plan and decide which benefits you need. You should also contact your local State Health Insurance Assistance Program (SHIP) to get free help choosing an insurance company in your area.
After buying a Medigap policy, make sure you carefully read and understand the summary of your policy. Ask questions if you don't understand anything, and keep the summary for your records.
Watch out for illegal practices by insurance companies. Every Medigap policy must follow federal and state laws designed to protect you.
