What are Medicare Supplements
Medicare Supplements, also known as Medigap plans, are sold by private insurance companies to help you cover the out-of-pocket costs left behind by Medicare. Think of them as a secondary insurance plan, with Original Medicare (Parts A and B) acting as your primary insurance.
When you have a Medicare Supplement plan, Original Medicare pays on your medical claims first, up to the limits set by those benefits. Then, your Medicare Supplement plan kicks in and pays for some or all of what’s left. The amount it picks up will depend on which Medicare Supplement you have.
What are the 10 Medigap Plans?
The ten Medicare Supplements are labeled with an alphabet letter. They include Plans A, B, C, D, F, G, K, L, M, and N. In addition, Plans F and G have high-deductible versions. These are often referred to as High-F or High-G.
What do Medicare Supplements cover?
Medicare Supplements cover any service, treatment, or procedure that has been approved by Medicare. As long as it’s covered by Part A or Part B, it will also be covered by your Medicare Supplement plan.
Part A offers coverage for hospitalizations. An easy way to remember what Part A covers is to think of it as your room and board coverage for any inpatient stays in a hospital or skilled nursing facility.
Part B offers coverage for outpatient medical treatment. This may be things like doctor’s office visits, lab work, imaging, surgeries, durable medical equipment, and preventive services like vaccines and screenings.
Both Part A and Part B have out-of-pocket costs. You’ll be responsible for deductibles, copayments, and coinsurance expenses. Your Medigap plan will pick up a majority of these costs. For example, if you have Plan G, your only out-of-pocket cost is the Part B deductible.
One question we often get asked is which providers accept Medicare Supplement plans. As long as your provider accepts Original Medicare, they’ll accept your Medicare Supplement plan. It does not matter which company you buy the plan from, as there are no provider networks. This is one of the benefits of having a Medigap plan instead of a Medicare Advantage plan.
What is not covered by Medigap?
To put it simply, if it’s not covered by Parts A or B, it’s not covered by your Medicare Supplement plan. However, it’s sometimes surprising when you learn about some of the things that aren’t covered by Original Medicare, so it’s important to be aware of where you might have gaps in coverage.
While there are a few intravenous medications that will fall under Part B, the majority of prescriptions are not covered by Original Medicare. If you have to go to your pharmacy (or order them by mail), your medications likely are not covered. Instead, you’ll need to enroll in a separate Part D prescription drug plan.
Part D plans are also sold by private insurance companies. Their costs and benefits will vary by plan, and you’ll likely have many to choose from. By working with a Medicare advisor at Bobby Brock Insurance, you’ll be able to choose the plan that works best for your current medication list.
Dental, Vision, and Hearing
Original Medicare does not cover any routine or preventive treatment for dental, vision, and hearing services. It will cover more serious conditions like glaucoma and macular degeneration but lacks coverage for the more basic services that most of us need.
Most beneficiaries choose to enroll in a Dental, Vision, Hearing (DVH) insurance plan to get help paying for these costs. You are not penalized for not having a DVH plan but be prepared to pay out-of-pocket if you don’t have a policy in place.
Long-term care is another thing many people are surprised to find Medicare doesn’t cover. Long-term care includes things like help with activities of daily living (ADLs), which includes bathing, eating, dressing, using the restroom, and transitioning from beds and chairs. You can receive long-term care help at home, in a nursing facility, or in an assisted living community.
The cost of long-term care is significant, often costing tens of thousands of dollars per month. To protect your retirement assets and get the quality of care you deserve, it’s wise to invest in a separate long-term care insurance plan.
How Much Will I Save with a Medicare Supplement Plan?
Medigap plans offer beneficiaries predictable coverage and out-of-pocket costs, which is a huge benefit as we plan our retirement budgets. They’re also a great way to save money, as they pick up many of the costs that remain after Original Medicare pays its share of the claims.
But how much money will you really save? Let’s break down Parts A and B so you can see all the costs that you could be responsible for.
First, Part A has a deductible that applies to inpatient hospital stays. The Part A deductible is quite different than any other you’ve probably seen. Instead of it being an annual deductible, it applies to every benefit period. A benefit period begins on the first day of your admission and ends when you’ve been out of the hospital for 60 days. So, you could have to pay that deductible multiple times in one year. As of 2023, the Part A deductible is $1,600. Every Medigap plan except Plan A includes coverage for the Part A deductible.
The deductible isn’t the only cost you’ll have under Part A. While Medicare does cover the first 60 days of a hospital stay, your costs are significant after that. Plus, coverage will max out after 90 days, leaving you with the entire bill.
Part B has an annual deductible. This year (2023), that deductible is set at $226 for the calendar year. Once you’ve met your deductible, you’ll be responsible for a coinsurance of about 20%.
That 20% doesn’t sound too bad, right? The biggest problem with having Original Medicare alone is that there is no cap on your out-of-pocket spending. Twenty percent of a doctor’s office visit won’t be much, but 20% of a major surgery would be a pretty scary number!
It can be difficult to plan for healthcare expenses, especially if you are someone who is in good health. However, the older we get, the more issues we might run into. It’s important to secure a Medigap plan while you are young and healthy because your health could prevent you from getting one when you need it most.
Bobby Brock Insurance can help you decide which Medigap plan is right for you. We’ll give you several options based on your health and budget, as well as the pros and cons of each choice. You don’t have to figure all of this out on your own. Our experts will guide you through the process and make sure you find the plans you need.
Medicare Supplement Frequently Asked Questions
Let’s review a few of the frequently asked questions about Medicare Supplements.
Will my doctor accept my Medicare Supplement?
As long as your doctor accepts Medicare, they’ll accept your Medigap plan. There are no provider networks with Medigap plans.
Can a company raise my rates if I file claims?
No! It is illegal for a health insurance company to raise your rates based on claims you filed. They also cannot terminate your coverage for filing too many claims. Medigap premiums are typically raised based on your age and economic inflation.
Which Medicare Supplement has the best coverage?
The best Medigap insurance plan for you is the one that fits your healthcare needs and budget. If you’re looking for the plan with the least out-of-pocket expenses, that’s Plan F! However, Plan G is nearly identical and may offer some valuable cost savings.
Are Medicare Supplement plans better than Medicare Advantage plans?
Nothing in Medicare is one-size-fits-all. Medicare Supplements and Medicare Advantage plans work very differently, so you’ll have to weigh the pros and cons to decide which one is right for you.
Do Medigap plans cover dental treatment?
No, Medicare Supplements do not cover dental treatment, except in very rare instances. You will need a separate dental insurance policy to avoid paying out-of-pocket for dental services.
How much do Medicare Supplements cost?
Medicare Supplement premiums vary based on which plan you choose, as well as your age, gender, and where you live. Plans that offer more coverage – like Plans F and G – will be more expensive than other plans. In addition, older individuals will pay more than younger ones.
This guide can be helpful if you’re considering buying a Medigap policy or already have one. It’ll help you know how Medicare Supplement plans work.
Earlier this month, the Centers for Medicare and Medicaid Services (CMS) released updates for the 2024 Medicare premiums, deductible, and cost-sharing amounts for Part A