Need an affordable
Medicare Supplemental Plan?
Compare Medicare Supplement plans in your area.
Need an affordable
Medicare Supplemental Plan?
Compare Medicare Supplement plans in your area.
Medicare Supplemental Plans
If you’re concerned about Medicare costs, a Medigap health insurance policy (also called Medigap supplemental insurance or a Medicare supplemental plan) helps pay the “gap” between what Original Medicare (Medicare Parts A and B) pays and what you pay out of your own pocket.
You can get a Medicare Supplement insurance policy through private insurance companies. You can get a Medicare Supplement insurance plan only if you already have Original Medicare. Medigap covers Medicare Part A (hospital insurance) and Medicare Part B (medical insurance), but it does not cover Medicare Part C (Medicare Advantage plans), Medicare Part D (prescription drug plans), or any other private health insurance, Medicaid, Veterans’ Administration benefits, or TRICARE.
Because Medigap policies are regulated by state and Federal laws, the benefits for all the coverage options are the same regardless of insurer. The differences will be in the price, who administers the plan, and which of the 10 options the insurer chooses to offer. Choose a health insurer you trust, and shop around for the best prices.
“All insurance companies selling a particular Medigap plan type in your area must offer the same coverage, but may offer it at different prices. So, you may want to shop for the best price.”
What Do Medigap Plans Cover?
Medicare Supplement cover some costs not covered by Original Medicare. For example, a 20% co-insurance bill for a doctor visit could be covered with a Medigap plan. All Medicare Supplemental insurance plans must cover standard services. Additional benefits are available with specific plans. All Medicare Supplemental insurance plans must cover:
Medicare Supplement generally don’t cover:
- Medicare Part A co-insurance costs up to an additional 365 days after Medicare benefits run out; co-insurance or co-payments for hospice care
- Medicare Part B co-insurance or co-payments
- Up to three pints of blood Other services covered depending on the plan:
- Skilled nursing facility care co-insurance
- Part A deductible
- Part B deductible (no longer covered for new Medicare beneficiaries)
- Part B excess charges
- Foreign travel emergency care
- Prescription drugs
- Vision
- Dental
- Long-term care
- Hearing aids
What you should know about Medigap
With ten different plan options, it can be challenging to understand what each plan offers and whether it’s right for you. Necessary coverage Medigap policies are not the same if you live in Massachusetts, Minnesota or Wisconsin. There are a few important changes and variations of the plan that you should know before choosing.
- Medicare Supplement Plan F and Plan G also offer a plan with a high deductible in some states. You must pay $2,340 in shared costs before regular Medicare 80/20 policy begins.
- As of January 1, 2020, new Medicare enrollees are not eligible for Plan C or Plan F. If you were eligible for Medicare before January 1, 2020, but did not enroll, you may still be eligible.
- Medigap Plans K and L pay 100% of covered services after you reach the annual out-of-pocket limit and pay the yearly Part B deductible. Your annual out-of-pocket limit and Part B deductible reset each calendar year. In 2020, the average Part B deductible is $198.
- Medicare Supplement Plan N pays 100% of the Part B co-insurance with certain exceptions. For example, an office visit co-pay of $20 or $50 co-pay for emergency room visits that don’t include inpatient admission.
Open enrollment for Medicare Supplement
Your open enrollment for Medigap supplemental insurance begins the first day of the month in which you turn 65 and are covered under Medicare Part B. You have six months to enroll. If you are under 65, check with your state’s Social Security Administration to see if it offers additional open enrollment periods.
“All insurance companies selling a particular Medigap plan type in your area must offer the same coverage, but may offer it at different prices. So, you may want to shop for the best price.”
Medicare Supplement coverage of pre-existing conditions
Medicare Part A and Part B typically cover pre-existing conditions. The same goes for Medicare Supplement insurance. The difference is, a company may be able to refuse to sell you a Medicare Supplement plan in the first place in some cases. As long as you buy a Medicare Supplement plan during the six-month Medicare Supplement Open Enrollment Period, the insurance company cannot refuse to sell you a plan.
The insurance company also can’t charge you more because you have health problems or make you wait for basic benefits to begin. However, you may have to wait up to six months for the Medicare Supplement policy’s benefits to include your pre-existing condition*.
If you apply for a Medicare Supplement insurance plan outside of your Medicare Supplement Open Enrollment Period, the private insurance company may “underwrite” the plan. Underwriting the plan means that you may be subject to a physical exam, and the insurance company can refuse to sell you the plan or they can adjust your premium based on your health status.
How insurance companies set Medigap premiums
There are three ways that an insurance company can set Medigap premium rates for Medicare Supplement:
- “Community-rated” (or “no-age-rated”) premiums are the same for everyone, regardless of age.
- “Issue-age-rated” (or “entry-age-rated”) premiums are based on your age when you first buy the policy. The sooner you buy, the less you will pay.
- “Attained-age-rated” premiums are based on your current age, meaning it goes up as you grow older.
Other factors impacting the premium rates of Medicare Supplement can include inflation, geography, medical underwriting (if you did not buy a plan when first eligible), and other discounts. You should check with each specific health insurer to see how it sets Medigap prices before you buy.
*Pre-existing conditions are generally health conditions that existed before the start of a policy. They may limit coverage, be excluded from coverage, or even prevent you from being approved for a policy; however, the exact definition and relevant limitations or exclusions of coverage will vary with each plan, so check a specific plan’s official plan documents to understand how that plan handles pre-existing conditions.
The product and service descriptions, if any, provided on these eHealth web pages are not intended to constitute offers to sell or solicitations in connection with any product or service. All products are not available in all areas and are subject to applicable laws, rules, and regulations.
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Medicare Supplemental Plans
If you’re concerned about Medicare costs, a Medigap health insurance policy (also called Medigap supplemental insurance or a Medicare supplemental plan) helps pay the “gap” between what Original Medicare (Medicare Parts A and B) pays and what you pay out of your own pocket.
You can get a Medicare Supplement policy through private insurance companies. You can get a Medicare Supplement only if you already have Original Medicare. Medigap covers Medicare Part A (hospital insurance) and Medicare Part B (medical insurance), but it does not cover Medicare Part C (Medicare Advantage plans), Medicare Part D (prescription drug plans), or any other private health insurance, Medicaid, Veterans’ Administration benefits, or TRICARE.
Because Medigap policies are regulated by state and Federal laws, the benefits for all the coverage options are the same regardless of insurer. The differences will be in the price, who administers the plan, and which of the 10 options the insurer chooses to offer. Choose a health insurer you trust, and shop around for the best prices.
“All insurance companies selling a particular Medigap plan type in your area must offer the same coverage, but may offer it at different prices. So, you may want to shop for the best price.”
What Do Medigap Plans Cover?
Medicare Supplement insurance plans cover some costs not covered by Original Medicare. For example, a 20% co-insurance bill for a doctor visit could be covered with a Medigap plan. All Medicare Supplemental insurance plans must cover standard services. Additional benefits are available with specific plans. All Medicare Supplemental insurance plans must cover:
- Medicare Part A co-insurance costs up to an additional 365 days after Medicare benefits run out; co-insurance or co-payments for hospice care
- Medicare Part B co-insurance or co-payments
- Up to three pints of blood Other services covered depending on the plan:
- Skilled nursing facility care co-insurance
- Part A deductible
- Part B deductible (no longer covered for new Medicare beneficiaries)
- Part B excess charges
- Foreign travel emergency care
Medicare Supplement insurance plans generally don’t cover:
- Prescription drugs
- Vision
- Dental
- Long-term care
- Hearing aids
What you should know about Medigap
With ten different plan options, it can be challenging to understand what each plan offers and whether it’s right for you. Necessary coverage Medigap policies are not the same if you live in Massachusetts, Minnesota or Wisconsin.
There are a few important changes and variations of the plan that you should know before choosing.
- Medicare Supplement insurance Plan F and Plan G also offer a plan with a high deductible in some states. You must pay $2,340 in shared costs before regular Medicare 80/20 policy begins.
- As of January 1, 2020, new Medicare enrollees are not eligible for Plan C or Plan F. If you were eligible for Medicare before January 1, 2020, but did not enroll, you may still be eligible.
- Medigap Plans K and L pay 100% of covered services after you reach the annual out-of-pocket limit and pay the yearly Part B deductible. Your annual out-of-pocket limit and Part B deductible reset each calendar year. In 2020, the average Part B deductible is $198.
- Medicare Supplement insurance Plan N pays 100% of the Part B co-insurance with certain exceptions. For example, an office visit co-pay of $20 or $50 co-pay for emergency room visits that don’t include inpatient admission.
Open enrollment for Medicare Supplement Plans
Your open enrollment for Medigap supplemental insurance begins the first day of the month in which you turn 65 and are covered under Medicare Part B. You have six months to enroll. If you are under 65, check with your state’s Social Security Administration to see if it offers additional open enrollment periods.
“All insurance companies selling a particular Medigap plan type in your area must offer the same coverage, but may offer it at different prices. So, you may want to shop for the best price.”
Medicare Supplement coverage of pre-existing conditions
Medicare Part A and Part B typically cover pre-existing conditions. The same goes for Medicare Supplement insurance. The difference is, a company may be able to refuse to sell you a Medicare Supplement in the first place in some cases. As long as you buy a Medicare Supplement during the six-month Medicare Supplement Open Enrollment Period, the insurance company cannot refuse to sell you a plan.
The insurance company also can’t charge you more because you have health problems or make you wait for basic benefits to begin. However, you may have to wait up to six months for the Medicare Supplement policy’s benefits to include your pre-existing condition*.
If you apply for a Medicare Supplement insurance plan outside of your Medicare Supplement Open Enrollment Period, the private insurance company may “underwrite” the plan. Underwriting the plan means that you may be subject to a physical exam, and the insurance company can refuse to sell you the plan or they can adjust your premium based on your health status.
How insurance companies set Medigap premiums
There are three ways that an insurance company can set Medigap premium rates for Medicare Supplement:
- “Community-rated” (or “no-age-rated”) premiums are the same for everyone, regardless of age.
- “Issue-age-rated” (or “entry-age-rated”) premiums are based on your age when you first buy the policy. The sooner you buy, the less you will pay.
- “Attained-age-rated” premiums are based on your current age, meaning it goes up as you grow older.
Other factors impacting the premium rates of Medicare Supplement plans can include inflation, geography, medical underwriting (if you did not buy a plan when first eligible), and other discounts. You should check with each specific health insurer to see how it sets Medigap prices before you buy.
*Pre-existing conditions are generally health conditions that existed before the start of a policy. They may limit coverage, be excluded from coverage, or even prevent you from being approved for a policy; however, the exact definition and relevant limitations or exclusions of coverage will vary with each plan, so check a specific plan’s official plan documents to understand how that plan handles pre-existing conditions.
The product and service descriptions, if any, provided on these eHealth web pages are not intended to constitute offers to sell or solicitations in connection with any product or service. All products are not available in all areas and are subject to applicable laws, rules, and regulations.
