What is a Medicare Supplement?
Medicare Supplements (sometimes called “Medigap”) are plans through private insurance companies that come in after Medicare pays for a service. The Medicare supplement pays afterward and pays either a portion or all of the remaining balance. Thus, it either reduces or eliminates the amount you’d have to pay after a medical service.
For example, if you had a doctors visit that costs you $1,000. Medicare would not pay the first $183 because of the deductible and then pay $653.60 since it only pays 80%. You’d have an additional $163.40 to pay. Your total bill for this service would be $346.40.
With the Plan F, it covers the deductible and the 20%. Which means you’d have no out-of-pocket expenses.
What Do Medicare Supplements Cover?
How to read the chart: If a check mark appears in a column of this chart, the Medigap policy covers 100% of the described benefit. If a row lists a percentage, the policy covers that percentage of the described benefit. If a row is
blank, the policy doesn’t cover that benefit. Note: The Medigap policy covers coinsurance only after you have paid the deductible (unless the Medigap policy also covers the deductible).
|Medicare Part A Coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up||✓||✓||✓||✓||✓||✓||✓||✓||✓||✓|
|Medicare Part B Coinsurance or Copayment||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓**|
|Blood (First 3 Pints)||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|Part A Hospice Care Coinsurance or Copayment||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|Skilled Nursing Facility Care Coinsurance||✓||✓||✓||✓||50%||75%||✓||✓|
|Medicare Part A Deductible||✓||✓||✓||✓||✓||50%||75%||50%||✓|
|Medicare Part B Deductible||✓||✓|
|Medicare Part B Excess Charges||✓||✓|
|Foreign Travel Emergency (Up to Plan Limits)||✓||✓||✓||✓||✓||✓|
*These plans have an out-of-pocket limit. Plan K has $5,120 and Plan L has $2,560.
**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 in which you are not admitted into the hospital.
Which Plan is for You?
As you can see from the chart above, Plan F is the most comprehensive plan, followed by Plan G, then Plan N. When selecting a plan, it is important to know that you can not “upgrade” a plan later with guaranteed issue. That means you’ll have to go through Medical Underwriting to qualify for the plan. If you buy a lower plan, and something happens and need to increase your benefits later, you may not have the opportunity to.
This is why I generally recommend that people enroll in Plan F when it is affordable. It’ll provide strong coverage for you for now and will continue to do so later when you’ll need it.