Finding a Medicare Supplement Plan that’s for you can feel like navigating a maze.
With so many different plans available, it’s difficult to know which one is right for your needs and budget.
We’ve put together this article to help you make sense of each plan, what they offer and how they might benefit you.
By the end of this article, you’ll be able to compare Medicare Supplement Plans and make an informed decision about which one will work best for you.
The federal Medicare program is health insurance designed for people 65 or older, certain people under 65 with disabilities and people of any age with End-Stage Renal Disease (ESRD).
There are also different parts of Medicare that help cover different medical services. These include:
Part A covers the care and treatment of patients in hospitals and other medical facilities. For example, hospice and nursing facility care.
Part B covers outpatient care and services. This includes bills for physical therapy and specialist consultations as well as vaccines and screenings.
Part D helps cover the cost of prescription drugs and is run by private insurance companies.
Also known as Medigap, a Medicare Supplement Plan is a health insurance policy that you can buy from private companies.
These plans help you pay for the remaining out-of-pocket costs that Medicare Part A and B don’t cover. Some of the expenses that Medicare doesn’t cover are:
There are 10 standardized Medicare Supplement Plans you can choose from. However, if you live in Wisconsin, Massachusetts, or Minnesota the policies work differently.
Depending on the plan you choose, Medicare Supplement Insurance can pay for:
Part of the expense that Medicare doesn’t cover (this is called the deductible)
20% of the amount you’re responsible for paying (the co-payment)
Any other additional medical costs
Medicaid is a government-run program that helps people with limited resources and income with their medical expenses.
A Medicare Advantage Plan (also known as Medicare Part C) is hospital and medical insurance provided by private companies, instead of the federal government.
One of the other advantages of a Medicare Supplement Plan is that they are “guaranteed renewable.”
This means that as long as you continue paying the premium, your Supplement Plan will be renewed each year and your coverage will continue—even if you develop health problems.
To qualify for a Medicare Supplement Plan, you must first have Medicare Parts A and B.
You should enroll in one of these plans during the Medicare Supplement Open Enrolment Period because you are likely to get better prices and have more choices available to you.
You must also be 65 or older for the Open Enrolment Period to begin.
This window only happens once in your life (unless you collect Social Security Disability Income) and lasts for six months.
The six-month window starts on the first day of the month that your Part B (Medical Insurance) enrolment is effective.
Do not confuse the Medicare Supplement Plan Open Enrolment Period with the Fall Annual Enrolment Period.
This window takes place every year between 15 October and 7 December and allows members of these plans to enroll, cancel or change their Medicare Advantage and Part D prescription drug plans.
When buying a Medicare Supplement Plan, it’s crucial that you understand which basic benefits each plan covers so that you can find the right one for your needs.
The comparison chart below shows the 10 standardized Medicare Supplement Plans that are available in most states.
Each plan can be identified by a letter: A, B, C, D, F, G, K, L, M and N. It’s very easy to get Supplement Plans mixed up with the different parts of Medicare.
This is why it’s important to keep in mind that Medicare Part B is not the same as Medicare Supplement Plan B, for example.
On the left-hand side of the chart, you can see the nine basic benefits that each Supplement Plan can cover.
|Medicare Part A Coinsurance and hospital cost up to an additional 365 days after Medicare Benefits are used||100%||100%||100%||100%||100%||100%||100%||100%||100%||100%|
|Medicare Part B Coinsurance or copayment||100%||100%||100%||100%||100%||100%||50%||75%||100%||100%|
|Blood (The first 3 pints)||100%||100%||100%||100%||100%||100%||50%||75%||100%||100%|
|Part A Hospice Care Coinsurance or copayment||100%||100%||100%||100%||100%||100%||50%||75%||100%||100%|
|Skilled Nursing Facility Care||100%||100%||100%||100%||50%||75%||100%||100%|
|Part A Deductible||100%||100%||100%||100%||100%||50%||75%||50%||100%|
|Part B Deductible||100%||100%|
|Part B Excess Charges||100%||100%|
|Foreign travel Emergency (up to plan limits)||80%||80%||80%||80%||-||-||80%||80%|
Here’s how to read the comparison chart:
Where you see a percentage, the Medicare Supplement Insurance Plan will cover that percentage of the benefit, and you must pay the rest.
Let’s say you choose Supplement Plan A. Medicare will cover 100% of the costs for the first four benefits.
However, Medicare does not pay for the other five benefits, which means you will have to cover those expenses.
Deductible: This refers to the set amount you pay for health care services before your insurance begins to pay. For example, if you have a $2,500 deductible you have to pay $2,500 before your insurance kicks in.
Coinsurance: The percentage of costs you pay after your deductible has been met.
Copayment: A set rate you must pay for doctor office visits, hospital stays and prescriptions.
Out-of-pocket expenses: This term refers to the medical expenses that you are required to pay for. Once you have reached the ‘out-of-pocket limit,’ the Supplement Plan should cover 100% of eligible health care expenses.
This is the most basic of all the Medicare Supplement Plans. Generally, this plan also has the lowest premiums compared to the others.
Although all Medicare insurance providers must offer Plan A, some states do not require these companies to offer it to people under 65 on Medicare Disability.
This is why it’s important you check with your State Insurance Department to see what your rights are under state law.
This plan covers everything that Plan A covers and the Medicare Part A hospital deductible.
Remember, you must not confuse this plan with Medicare Part B, which is part of your Original Medicare benefits that covers outpatient treatment and services.
This is one of the most comprehensive and popular supplement plans because it covers all benefits except the Medicare Part B excess charges.
Along with Plan F, this plan will not be available to people who are newly eligible for Medicare Supplement Plans on or after 1 January 2020.
Although Medicare Supplement Plan D covers most benefits, it does not cover the Part B deductible or any Medicare excess charges.
This plan should also not be mistaken for Medicare Part D, which is designed to cover prescription drugs.
Plan F is one of the most popular Medicare Supplement Plans because it covers all benefits and leaves no out-of-pocket expenses.
This means that you will not have any co-payments if you visit a doctor, are admitted to hospital, or after emergency room visits.
As mentioned before, this plan is not available to people who are newly eligible for Medicare Supplement Plans on or after 1 January 2020.
Due to Plan F’s eligibility requirements, Plan G has become very popular in recent years.
This is because it covers almost everything that Plan F covers, except for the Part B deductible.
In some states, Plans F and G offer a high-deductible plan. This means that your monthly premiums will be lower, but you will be required to pay more out-of-pocket expenses.
In the case of these plans, you must pay a deductible fee of $2,370 before your policy pays anything.
These plans work slightly differently because they offer partial coverage of certain benefits and have annual out-of-pocket limits.
If you choose one of these plans, it’s important to note that they have out-of-pocket limits of $6,220 and $3,110.
Once you have paid these amounts and the Part B deductible ($223, as of 2022), the plan will pay 100% of your Medicare covered costs for the rest of the year.
These plans cover the same benefits as Plan D, except Plan M covers the Part A deductible at 50% and Plan N covers the Part B coinsurance but requires copayments.
This means that you will have to pay up to $20 for doctor visits and $50 to go to the emergency room (as long as you are not admitted to hospital).
Generally, Plan N has lower premiums because it requires you to cover the copayments.
One of the most important factors to consider when you compare Medicare Supplement Plans is how much it will cost you long term.
The plans are generally standardized across America and the prices will vary depending on which state you’re in.
This means that the benefits of Plan N in Ohio will be the same in North Carolina, for example.
There are three ways that insurance companies set premiums for Supplement Plans. These include:
Community-rated: This premium is not based on your age. This means that the same monthly premium is charged to everyone. However, the price will vary according to inflation.
Issue-age rated: This premium will be based on the age you are when you buy the policy. Therefore, the premium is lower for people who buy it at a younger age and won’t change as they get older.
Attained-age rated: This premium is based on your current age and will go up as you get older. Although these premiums might be the least expensive at first, they will eventually become the most expensive and are also affected by inflation.
Although the benefits of Medicare Supplement Plans are standardized, the prices can vary significantly.
This is because different insurance companies may charge different premiums for exactly the same health insurance coverage.
PolicyScout can offer expert consultation on choosing the right Medicare Supplement Insurance.
We’ve ranked and reviewed the top providers, which allows us to advise on which coverage would work best for your needs and budget. If you’d like to learn more, send us an email.
Choosing a Medicare Supplement Plan is a big decision. You want peace of mind that the plan will cover your medical expenses if you become ill, and that you will be able to continue paying the premiums to receive medical coverage.
This is why it’s important to weigh up the costs and the benefits of each plan, as well as if it’s available in your area.
Make sure that you check with your State Insurance Department to see if the Medicare Supplement Insurance Plan you are interested in is available where you live.
To help you decide which plan is right for you, ask yourself these questions:
Which basic benefits are the most important to me?
How often will I need to use my Medicare Supplement Plan? (In other words, do you need to see the doctor regularly?)
How much is the monthly premium?
Will I be able to afford the premium when the price increases each year with inflation?
How much am I willing to spend on out-of-pocket expenses?
Once you have answered all these questions, you will be able to see which plans offer the best benefits for your health care needs and will fit your budget.
At PolicyScout, we know that finding the best Medicare Supplement Plan for your unique needs can be overwhelming.
One of our licensed Medicare insurance experts will help you find the right coverage at a price that suits your budget.
Talk to one of our expert consultants today, risk free and for no charge.