July 28, 2022

What is Medigap Insurance: Medicare Supplement Insurance Benefits, Medigap Coverage, and Medigap Insurance Plan Cost

Does the thought of shopping for Medicare Supplement insurance make your head spin? If you’re like most people, the answer is probably yes. There’s a lot of information, and it can be hard to know where to start.

But don’t worry – we’re here to help. In this article, we’ll give you the lowdown on Medigap insurance. We’ll tell you what it is, how it works, and what it can do for you. We’ll also answer some of the most common questions about Medigap insurance.

So, what are you waiting for? Let’s get started!

What is Medicare Supplements Insurance?

Medigap insurance is health coverage provided by private insurance companies designed to pay for costs not covered by Original Medicare. These plans are regulated by the United States government and standardized across all states except Massachusetts, Minnesota, and Wisconsin.

Benefits of Medigap Insurance include:

Coverage for services that Original Medicare does not cover, such as travel outside the US.
Protection against high out-of-pocket costs
Coverage for copayments, Coinsurance, and deductibles

Depending on your Plan, Medigap insurance companies may include additional added value health benefits such as no-cost gym memberships.

When is the Best Time to Sign up for Medicare Supplement Insurance?

The best time to sign up for Medical gap Insurance is during the Medicare initial open enrollment period. This six-month period begins on the first day of the month you’re both 65 years old and enrolled in Medicare Part A and B.

You can enroll in any Medigap plan available in your state without undergoing medical underwriting. Medicare insurance companies cannot refuse to sell a health insurance policy or charge you more because of pre-existing health conditions.

This is your guaranteed issue period to buy a standardized Medigap plan.

After your Medigap open enrollment period ends, you must undergo medical underwriting to buy a Medigap plan.

What are the Differences Between Medigap and Medicare Advantage Plans - Part C?

Medigap insurance helps bridge the gaps in your Original Medicare coverage. It can help pay out-of-pocket costs not covered by Medicare, such as copayments, coinsurance, and deductibles. Private Medicare insurance companies offer it.

By enrolling in a Medicare supplementary plan, you remain on Original Medicare. Original Medicare allows you to see any doctor or medical facility throughout the US.

Medicare Beneficiaries are not required to obtain a referral to see a specialist and do not need pre-authorization for medical procedures deemed medically necessary by their doctor.

When enrolled in a Medigap plan, you have the option to sign up for a standalone Medicare Part D prescription drug plan.

Medicare Advantage plans assume your Original Medicare benefits through a private insurance company that becomes your primary insurer. These plans may offer additional supplemental benefits, such as prescription drugs or dental, hearing aid, and vision coverage.

You cannot enroll in both Medigap and Medicare Advantage plans simultaneously. Medicare beneficiaries enrolled in a Medicare Advantage plan are not allowed to sign up for a standalone Part D plan and must accept the Part D plan included in their coverage.

If you do not have creditable prescription drug coverage, it is vital to sign up for a Part D plan. This will ensure you will avoid any late enrollment penalties in the future by enrolling in a Medicare Part D plan when you enroll in a Medigap plan or a Medicare Advantage plan.

What are the Basics of Medicare Supplement Plans?

Medigap insurance is health coverage provided by private companies designed to pay for costs not covered by Original Medicare. These costs might include copayments, coinsurance, deductibles, and services that Original Medicare doesn’t cover.

Medigap premiums may be based on factors including your gender, age, where you live if you smoke, and your marital status.

In addition to these ten Medigap plans, some states may include a high-deductible version of Medigap Plan G. These high deductible Medicare supplement plans reduce your monthly cost but can add higher costs once you use the Plan in the future.

The cost comparisons of Medigap insurance will vary by state, person, and health insurance provider.

A Closer Look at Some of the Most Popular Medigap Plans

Medigap plans are standardized, so you only need to choose the plan letter corresponding to your Medicare Part A and B enrollment. The most popular Medigap plans are Plan F, Plan G, and Plan N.

Plan F is the most comprehensive Plan and offers coverage for:

Part A coinsurance and hospital costs
Part B coinsurance or copayment
The first three pints of blood
Part A hospice care coinsurance or copayment
Skilled nursing facility care Coinsurance
Part A deductible
Part B deductible
Part B excess charges

Plan F is the most expensive Plan as the Plan picks up all covered health insurance costs. However, Plan is no longer available for new Medicare beneficiaries who turn 65 after January 1, 2020.

Plan G is similar to Plan F but does not cover the Part B deductible.

Part A coinsurance and hospital costs
Part B coinsurance or copayment
The first three pints of blood
Part A hospice care coinsurance or copayment
Skilled nursing facility care Coinsurance
Part A deductible
Part B excess charges

Plan N covers:

Part A coinsurance and hospital costs
Part B coinsurance (You are responsible for up to a $20 copayment for office visits and up to a $50 copayment for emergency room visits)
The first three pints of blood
Part A hospice care coinsurance or copayment

When choosing a Medigap policy, some Medicare insurance companies offer household discounts when spouses sign up with the same company. This means that if you and your spouse both enroll in Medigap plans, you may be able to get a discount on your premiums.

What are the Differences Between Medigap Policies?

Private insurance companies sell 10 standardized Medicare supplement plans. Each Plan provides a different level of healthcare benefits. These plans are identified by the letters A through N.

Plan A is the most basic, and Plan F is the most comprehensive.

Not all insurance companies offer all 10 health care plans, so you must compare policies before you purchase one. Some Medigap policies offer additional benefits, such as dental or vision coverage.

To be eligible for a Medigap policy, you must enroll in Medicare Part A and Part B. You must also pay your Medicare Part B premium.

One of our Medigap insurance agents can help you find a plan that best meets your medical needs.

What are the Questions to Ask When Considering to Enroll in a Medigap?

There are a few questions you should ask when considering Medigap insurance:

What is the monthly premium?
Does the Plan include a deductible?
What is my coinsurance obligation?
What is the out-of-pocket maximum?
What Medicare services are covered?
Do my providers accept Medicare?
Can I cancel my policy at any time?

What are the Emergency Situations in which Supplemental Coverage can help?

Medigap plans are designed to help cover certain medical expenses. Medigap plans can also help you cover medical costs while traveling abroad or on a cruise ship.

International health insurance coverage is typically capped at $25,000 or $50,000, depending on the Medicare supplement insurance company. It is recommended when traveling internationally to obtain a travel accident policy.

These policies include higher coverage options and may also cover emergency transportation costs.

When considering a Medigap plan, comparing quotes carefully with a licensed Medicare insurance agency is essential. This will ensure that you find the Plan that is best for you.

What type of Coinsurance does Medicare Supplemental Health Care Insurance Cover?

There are ten different Medigap insurance plans, each with a different set of benefits. One of the benefits that all Medigap plans offer is coinsurance coverage. Coinsurance is when you share the cost of your medical care with your insurance company.

For example, if you have a $100 doctor’s bill, and your coinsurance is 20%, you would pay $20, and your insurance company would pay $80.

There are two types of Coinsurance that Medigap plans cover Medicare Part A coinsurance and Medicare Part B coinsurance.

Medicare Part A covers inpatient hospital visits, skilled nursing facility care, and home health care. The Medicare Part A coinsurance is the portion of your hospital bill you are responsible for paying.

Medigap plans cover all or part of the Medicare Part A coinsurance, depending on your Plan.

Medicare Part B covers outpatient care, including doctor’s visits, preventive care, and home health care. The Medicare Part B coinsurance is the portion of your outpatient bill you are responsible for paying. Medigap plans cover all or part of the Medicare Part B coinsurance, depending on your Plan.

Some Medigap plans also cover the Medicare Part A deductible and the Medicare Part B deductible.

Does Medigap Insurance Cover Part D Prescription Drug Costs?

So what does Medigap insurance cover for drug costs? Generally speaking, Medigap plans do not cover prescription drugs. However, there are some exceptions to this rule.

For example, if you have a Medigap plan purchased before 2006, it may cover some of your prescription drug costs. Additionally, your Medigap plan must offer prescription drug coverage if you live in Massachusetts, Minnesota, or Wisconsin.

If you live in any other state, it is up to the individual insurance company whether or not they want to offer this type of coverage.

What Do Medigap Plans Not Cover?

While Medigap plans can offer enhanced benefits like coverage for coinsurance and copayments, there are several things that most Medicare supplement plans will not cover. These include:

Comprehensive Dental
Vision
Hearing Aids
Long Term Care

Each Medigap plan is different, so review the letter plan carefully with your Medicare insurance agent.

What is Medigap Coverage used for?

Medigap plans are designed to cover out-of-pocket costs for services covered by Medicare, as opposed to care that Medicare doesn’t cover and that the enrollee has to pay entirely out-of-pocket.

This means that Medigap can be used to cover things like:

The 20% coinsurance for Medicare Part B
The deductibles for both Medicare Part A and Part B
Hospice care coinsurance or copayments
The first three pints of blood you need in a year

While Original Medicare provides excellent health care services, it does not provide full coverage. Thus, anyone with Original Medicare coverage can benefit from a Medigap plan.

Most Medigap plans will cover the 20% coinsurance, leaving you with no additional Medicare Part B out-of-pocket costs after you meet the annual deductible. This can save you significant money on your healthcare costs each year.

Changing or Choosing a Medigap Plan

Before new enrollees can purchase supplemental insurance for seniors sold by private companies, you must first be eligible for Medicare Part A and enrolled in Part B.

You have a 30-day free-look period during which you can make your plan changes without penalty. After your initial Open Enrollment Period, you are generally subject to underwriting health questions when making changes or applying to a Medigap plan.

You must pay the monthly premium even if you do not use the Plan.

Medsupp plans cover a range of different medical expenses. It would be best if you choose a Medigap plan that covers the costs that are important to you.

For example, if you are concerned about protecting the costs of hospitalization and outpatient care, you should choose comprehensive coverage such as the Medicare supplement Plan G.

Depending on your state, you may qualify for the birthday rule. This allows you to switch insurance providers without medical underwriting during specific times of the year.

What are the ways to Lower the Price of a Medigap Insurance Plan?

The prices of Medigap insurance can vary depending on various factors, such as the state you live in, your age, gender, whether you smoke, and the type of policy you have.

There is a range of ways to lower the price of Medigap insurance. Some states have higher premiums than others. In some cases, you may be able to get a discount if you purchase a policy through a group plan. There is also a high-deductible version of Medigap Plan G that can be an option in some states.

Using Medicare Insurance Brokers like Integrity Now Insurance Brokers allows you to shop multiple insurance companies through one central person. The insurance representative will sell you a Medigap policy that is best for your current needs.

Technology allows you to purchase a Medigap policy quickly right over the phone.

What are the Factors that Affect the Cost of Medicare Supplemental Insurance?

There are a variety of factors that affect the cost of Medsupp insurance. The main element is the age of the person buying the policy and the state where you reside.

In general, rates increase as you get older. Another critical factor is whether you smoke tobacco. People who use tobacco products will pay more for their Medigap policies than people who do not use tobacco products.

How do Massachusetts, Minnesota, and Wisconsin Differ in their Medigap Coverage Plans?

The following states offer different insurance coverage plans.

Massachusetts provides Medicare Parts A and B cost coverage similar to standardized plans, but the plans are state mandated to cover pap tests and mammograms, among other services.

Minnesota offers four modified plans of the 10 provided in other states, but it offers two unique plans: the Basic Plan and the Extended Basic Plan. Each of these offers different percentages of cost coverage than the plans offered in the other 47 states, along with state-mandated benefits such as equipment and supplies for diabetes care.

Wisconsin offers its own Basic Plan, with different percentages of coverage than the standardized plans. It includes coverage for 40 more home healthcare visits than what Medicare pays and additional inpatient mental health coverage.

Is there Anything in Addition to Medigap Insurance that I need?

No, Medigap insurance is all you need in addition to Medicare. You may need to obtain a Medicare Part D prescription drug plan if you do not have creditable coverage through an employer plan or the Veterans Administration.

You may also consider Vision, Dental, and Hearing Aid coverage.

Why Should You Buy a Medigap Policy?

There are several reasons why you should buy a Medigap policy.

First, if you have a Medigap policy, you will have peace of mind knowing that you have coverage for the things that Original Medicare doesn’t cover. This can give you peace of mind and help you budget your health care costs.

Second, a Medigap policy can help you save money on health care costs. When you have a Medigap policy, it removes any surprises bills you would face without it.

Third, a Medigap policy can help you get the necessary health care. When you have a Medigap policy, you will have access to a network of doctors and hospitals agreeing to provide care at a discounted rate to Medigap policyholders. This removes the high-cost burden, which may stop you from seeing a doctor.

Fourth, a Medigap policy can help you protect your assets. If you have a Medigap policy, your family will not have to use your assets to pay for your health care costs if you need to go into a nursing home.

How can I Enroll in Medigap insurance?

If you are interested in Medigap insurance, Integrity Now Insurance Brokers is here to help answer your questions and enroll you into a Medicare supplement policy. If you are already enrolled in a Medigap plan, one of our licensed insurance agents can provide you with a no-cost review.

Free personalized recommendations are also available. You can find a plan that fits your health needs and lifestyle.

How to Find the Best Medicare Insurance Agency

The best way to find a reputable Medicare Insurance Agency is to ask for recommendations from friends and family. You can also search for agencies online and read reviews from other consumers.

When you’ve found a few agencies you’re interested in, you’ll want to compare their rates and coverage options.

Once you’ve found an agency you’re comfortable with, you can start buying a Medigap plan. They can help you compare different plans and find the one that’s right for you.

Integrity Now Insurance Brokers is one of the top Medicare Insurance Agencies serving all 50 states. We are here to help you compare different insurance providers and plans that best meets your needs. Give us a call today!

Frequent Asked Questions:

Who is Eligible for Medicare?

Medicare is a health insurance program for people 65 years of age or older, people under 65 years of age with specific disabilities, and people of any age with End-Stage Renal Disease (ESRD).

What does Medigap Plan G Cover?

Medigap Plan G covers the same benefits as Plan F, with the exception of the Part B deductible. This means it covers Medicare Part A and Part B coinsurance and copayments, skilled nursing facility care coinsurance, Part A hospice care coinsurance or copayments, and Part B excess charges.

Do Medicare Supplement Coverage Change Annually?

No, Medicare supplement coverage does not change annually. Unlike Medicare Advantage plans, Medigap plans remain the same forever. However, your premiums may change if your insurance carrier adjusts its rates.

What do Medigap Plan Letters Mean?

The Medigap plan letters (A through N) refer to the available types of Medigap plans. Each Plan offers different benefits, so you’ll want to compare them to see which one is right for you.

Should I Sign up for a Medicare Supplement or Advantage Plan?

What’s your budget?

Supplement plans can be expensive, so you’ll need to consider your budget when making a decision. If you have a limited budget, an Advantage Plan may be a better option for you.

What’s your health situation?

If you have a chronic health condition, you may need a Supplement Plan that covers more than an Advantage Plan. You’ll need to consider your health situation when making a decision.

What do you want to be covered?

Advantage Plans cover more than Supplement Plans, but they may not cover everything you want. You’ll need to consider what you want to be covered before making a decision.

Making a decision about whether to sign up for a Medicare Supplement or Advantage Plan can be difficult. There are a lot of factors to consider. But, if you take the time to consider your budget, your health situation, and what you want to be covered, you’ll be able to make the best decision for you.

What is the Monthly Premium for Medigap Insurance?

The premium for Medigap insurance is based on your current location, age, Plan selected, and health problems if enrolled outside your guaranteed eligibility period.

Can Medigap Premiums Increase?

Yes, Medigap premiums can increase. However, the amount that they can increase is limited by law. The most common reason your premiums increase is becoming older, as most Medicare supplement plans are age-banded policies.

Can I Switch from Medicare Advantage to Medigap?

Yes, you can switch from Medicare Advantage to Medigap. You can do this at any time during the year.

Can I Sign up for Original Medicare Coverage only?

Yes, you can sign up for Original Medicare only. This means you will be enrolled in Medicare Part A and Part B but not in Medicare Part D or a Medicare Advantage Plan. You will be responsible for paying the monthly premiums for Part A and Part B and any deductibles, copayments, and coinsurance associated with these programs. If you decide to enroll in a Medicare Advantage Plan or Part D later, you must disenroll from Original Medicare first.

When should I sign up for Prescription Drug Coverage?

There are a few things to consider when signing up for Prescription Drug Coverage. First, you must decide if you want coverage through a private insurer or a government program like Medicare. If a private insurer covers you, you should check with your Plan to see if prescription drug coverage is included. If it is not, you can usually add it on for an additional cost. If a private insurer does not cover you, you can sign up for Medicare Part D, the prescription drug coverage part of Medicare. You can sign up for Part D during your Initial Enrollment Period, which starts three months before you turn 65 and ends three months after you turn 65. You can also sign up during the Annual Enrollment Period from October 15-December 7 each year.

How Do I Buy a Medigap Plan?

Once you’ve decided on the right Medigap plan, it’s time to start shopping!

There are a few different ways to buy a Medigap plan. You can buy a plan directly from an insurance carrier or work with a Medicare Insurance Agency.

If you decide to buy a plan directly from an insurance carrier, compare rates and benefits from multiple companies before making a decision.

If you decide to work with a Medicare Insurance Agency, we can help you compare rates and benefits from multiple insurance companies. We’ll also help you choose the right Plan for your needs and budget.

To get started, contact us today, and we’ll be happy to help you find the perfect Medigap plan for you!