What Is the Most Common Medigap Plan?
One option Medicare beneficiaries have to complete their health insurance coverage is a Medigap plan. Medigap plans are great choices for those who are looking for predictable, comprehensive coverage. But it’s not quite that simple. Even once you decide you’d like to enroll in Medigap, you’ll still have a few choices to make.
To quickly narrow down the choices, most of our clients ask, “What is the most common Medigap plan?” We can answer that question quickly, but it’s important to have an understanding of why the answer is what it is. Today, we’ll explain why Plan G is the most common Medigap plan.
What Are Medigap Plans?
When it comes to health insurance, peace of mind is invaluable. We all want to know that if an unexpected medical expense pops up, we’re covered. That’s where Medigap plans, also known as Medicare Supplement plans, come into play.
Medigap plans are supplemental health insurance policies designed to fill in the “gaps” in Original Medicare, which includes Part A (hospital insurance) and Part B (medical insurance). While Parts A and B offer great coverage, they leave beneficiaries with quite a few out-of-pocket costs. A Medigap plan will pick up some or all of the remaining deductibles, copays, and coinsurance amounts.
Let’s take a closer look at what Medigap plans offer.
- Coverage of Out-of-Pocket Costs: Depending on the specific Medigap plan, various out-of-pocket costs like deductibles, copayments, and coinsurance expenses become the responsibility of the Medigap policy, not you.
- Provider Flexibility: Beneficiaries with a Medigap plan can choose to see any provider or healthcare facility that accepts Medicare, with no need for referrals. Since most providers accept Medicare, you’ll have lots of options and won’t be limited on where you can get the care you need.
- Foreign Travel Coverage: Most Medigap plans include emergency coverage when you are traveling outside of the country. You won’t find this benefit in Original Medicare.
- Stability: As long as you continue to pay your monthly premium, your Medigap plan will never change. Medigap plans offer standardized coverage, so their benefits are easy to understand. You’ll have stable benefits and predictable costs.
It’s important to know that Medigap plans don’t cover long-term care or preventive vision, dental, or hearing services. You’ll have other options when it comes to insurance for those services, so be sure to discuss this with your advisor.
Lastly, we mentioned that Medigap plans have standardized benefits. This means that a Plan G (or any other plan letter) offered by one insurance company will provide the same benefits as a Plan G offered by another company. The primary difference usually lies in the premium, customer service, and additional perks offered by the provider.
Ready to learn more about the most common Medigap plan? Let’s go!
Plan G: The Most Common Medigap Plan
Medigap Plan G is currently the most common Medicare Supplement plan on the market. It offers extensive coverage and has no eligibility requirements other than being enrolled in Medicare Part A and B. It covers the following expenses:
- Part A deductible
- Part A hospital costs, with an extra 365 days of coverage
- Part A skilled nursing costs
- Part A hospice costs
- First 3 pints of blood
- Part B copayments
- Part B coinsurance costs
- Part B excess charges
- Foreign travel emergencies
That list entails nearly every out-of-pocket cost you could experience on Original Medicare. The only thing not covered? The Part B deductible.
As of 2020, newly eligible beneficiaries could not enroll in any plan that offered “first dollar coverage.” That change in law meant that people could no longer enroll in the plans that did cover the Part B deductible. Plan G remains the most comprehensive option for anyone new to Medicare.
Another reason Plan G is a popular choice is due to its cost-benefit analysis. While there are other plans with slightly lower premiums (and we’ll talk about those soon), the potential out-of-pocket costs are higher. That risk may not be worth saving a few dollars in premiums. With Plan G, beneficiaries often find that the higher premium is well worth the peace of mind and reduced out-of-pocket costs in the long run.
Other Popular Medigap Plans
While Plan G often steals the spotlight, it’s not the only Medigap plan that deserves attention. Plans F and N have also garnered popularity over the years and remain excellent choices.
Medigap Plan F
If you had asked us what the most common Medigap plan was a few years ago, we would have told you Plan F. For many years, it held the title of the most comprehensive Medicare Supplement plan available.
Remember the list of covered benefits we outlined with Plan G? Take all those, toss in the Part B deductible, and you have a complete list of Plan F benefits. There aren’t any costs missing from what Plan F covers. That’s right, beneficiaries who enroll in Plan F have virtually no out-of-pocket costs for approved medical services. Of course, it also has higher premiums than Plan G.
However, as we mentioned earlier, no newly eligible Medicare beneficiary can enroll in Plan F, which has led to a stagnation in its pool of enrollees. Anyone who was already enrolled in Plan F can keep their plan.
Medigap Plan N
Plan N is another popular Medigap plan, but it doesn’t get as much attention as Plans F or G. But for those looking for a cost-effective alternative, Plan N strikes a balance between comprehensive coverage and affordable premiums.
Like Plan G, Plan N does not pick up the Part B deductible. In addition, it does not pay any Part B excess charges. An excess charge is an amount over and above the fee that Medicare has approved for a service. Providers who do not wish to accept Medicare assignment may charge an excess charge, which can be up to an additional 15% of the Medicare-approved amount. Part B excess charges are rare since so many providers accept Medicare. In addition, there are eight states that do not allow excess charges at all.
Plan N also requires copays for doctor and emergency room visits. You’ll pay up to $20 for a doctor’s visit and up to $50 for an emergency room visit. If your emergency room visit results in an inpatient admission, the copay is waived.
The appeal of Plan N is in its premium. It’s often $40-$60 dollars cheaper than Plan G. Beneficiaries who are healthy and don’t visit the doctor frequently often find value in Plan N.
How to Choose a Medigap Plan
There isn’t a thing in Medicare that is a one-size-fits-all solution. Just because Plan G is the most popular Medigap plan doesn’t mean it’s right for you. Choosing a Medigap plan involves careful consideration of a number of factors to make sure it aligns with your medical needs and your budget. So, how do you choose a Medigap plan?
Start by thinking about your health needs. Evaluate your current health status and family history, and try to anticipate services or treatment you might need in the future. If you frequently visit specialists or expect major surgeries, you might lean toward a plan with more coverage.
In that same vein, you’ll also need to consider your budget. Do you want to pay upfront for higher premiums or higher costs later if you need medical treatment? Which option works better for your budget? You may need to consult past medical bills to get insights on your healthcare expenses. Work with your advisor to analyze the monthly premiums against potential out-of-pocket costs.
Learn More About Plan G
Medicare might be a maze, but it’s one that we all have to get through sooner or later. Learning the ins and outs of Medicare is essential to ensure your physical and financial health. Medicare Supplements like Plan G are a great way to shield yourself from unexpected medical costs. While Plan G might be the most common Medigap plan, you should work with your advisor at Bobby Brock Insurance to assess all your options.
Want a personalized assessment of your Medicare options? Bobby Brock Insurance is here to guide you. Reach out to our experienced team today, and let’s ensure you’re on the path to the best healthcare coverage for your future.