Medicare Supplements
Also known as “Medigap”, are sold by private insurance companies and are designed to cover the types of expenses that Medicare pays toward but doesn’t fully cover (deductibles, copayments and coinsurance).
In other words, Medicare pays its share of Medicare-approved amounts and a Medicare Supplement pays towards the balance of these Medicare-approved amounts. Currently there are 10 different “Standard” Medicare Supplements that can be purchased- each one pays towards that balance a little differently. By “standard”, we mean a Plan G from one company is exactly the same as another company’s Plan G- the only difference is the premium.
The chart below shows how each Supplement will fill in the gaps. Notice how Plan G currently fills all the gaps except for the Part B deductible. (See note below chart for new rules on Plan C and F plans)
| Standardized Medicare Supplement Plans | ||||||||||
| Medicare Supplement Benefits | A | B | C* | D | F* | G | K | L | M | N |
| Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted | X | X | X | X | X | X | X | X | X | X |
| Medicare Part B copayment or coinsurance | X | X | X | X | X | X | 50% | 75% | X | X**** |
| First three pints of blood | X | X | X | X | X | X | 50% | 75% | X | X |
| Medicare Part A hospice care coinsurance or copayment | X | X | X | X | X | X | 50% | 75% | X | X |
| Skilled nursing facility care coinsurance | X | X | X | X | 50% | 75% | X | X | ||
| Medicare Part A deductible | X | X | X | X | X | 50% | 75% | 50% | X | |
| Medicare Part B deductible | X | X | ||||||||
| Medicare Part B excess charges | X | X | ||||||||
| Foreign travel emergency coverage (up to plan limits) | 80% | 80% | 80% | 80% | 80% | 80% | ||||
| Out-of-pocket limits apply. | ||||||||||
As of January 1, 2020, the following rules apply to Medicare Supplements Plan C and Plan F:
- If you already have a Medicare Supplement Plan C or F, you can keep it.
- Eligible for Medicare before 1/1/20? You can buy a Plan C or F. However, you would pay a higher premium for basically paying the Part B annual deductible ($198 in 2020). In most cases, you would save money by choosing a Plan G and paying the Part B deductible yourself.
- Eligible for Medicare 1/1/20 and thereafter? You cannot buy a Plan C or F.
General notes about Medicare Supplements:
- To purchase a Medicare Supplement, you must have “original” Medicare Part A and Part B.
- Medicare Supplements are Guaranteed Renewable- you can’t be cancelled as long as you pay your premium.
- If you have a Medicare Supplement, you most likely will need to purchase Medicare Part D to help with prescriptions.
- You only need ONE Medicare Supplement.
- If you choose a Medicare Advantage Plan (Medicare Part C), you would not need a Medicare Supplement and a Part D plan.
- Medicare Supplements generally don’t cover custodial long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.
- If you decide to switch to Medicare Part C (a Medicare Advantage plan) and are not happy with it, you have 12 months to switch back to original Medicare and pick up a Medicare Supplement and a Part D plan without any health questions. Outside of 12 months, you would be subject to underwriting and may be turned down.
Questions or would like further information? Please feel free to call me at (910) 775-0700 for a FREE consultation!