How to easily compare Medigap plans in 2024
It is not easy to compare and understand the many Medicare Supplement (Medigap) Plans with all their different benefits and costs. To get a better understanding, read our explanation and comparison below, which explains all your options.
What you need to know about Medigap plans in 2024
Medigap plans, also referred to as Medicare supplement plans or supplemental insurance, are offered by private insurance companies, approved by the federal government and CMS/Medicare.
The plans are standardized, defined by letters. All plans cover basic benefits, and each has different additional benefits. Which of the plans, labeled A, B, D, G, K, L, M, N, are available to you depends on your local area. Each plan comes with a different set of benefits to compensate for gaps under the healthcare law, helping you cover some or all of the cost for co-payments and deductibles that are not covered by traditional Medicare. Every insurance provider must give you the exact same benefits for the plan you select – but each insurer is free to set its own price. Since the cost can vary greatly among insurance companies, it is important to comparison shop, before you decide which Medigap policy is best for you.
How and when can I buy Medigap?
You have a guaranteed issue right to join a Medigap plan, regardless of past or current health issues, when you first become eligible for Medicare, but only for six months during your Medigap Open Enrollment Period, which starts the first month you turn 65 and are enrolled in Medicare Part B.
After that – except in specific circumstances -, insurers may use underwriting, which means any health issues you have or had will be considered, and may influence your acceptance or monthly premium.
It is important to know that your Medicare Part A and B are still your primary coverage, if you purchase a Medigap plan. If a health care provider accepts Medicare, they will typically accept your Medicare supplemental insurance. Unlike Medicare advantage plans, there is no network of providers you must use. You may see any doctor that accepts Medicare. When it’s time to pay your bill, Medicare will first pay its share, and then your supplemental insurance will take care of the remainder, to the extent as it is covered by the plan you select.
Benefits comparison of Medigap plans
As you may know, Medicare only pays 80% of your approved medical costs. If you want additional coverage, you may add one of the currently eight different Medigap plans A through N to your original Medicare. However, the benefits and premiums for each ‘letter’ vary greatly. Here is a brief overview:
All Medigap plans include Medicare Part A (hospital) coinsurance and coverage for hospital benefits up to an additional 365 days after Medicare benefits are used up. However, the deductible you may have to pay as an inpatient for Part A is not covered in some plans.
Also, the part B deductible is not covered at all by currently available Medigap plans. All plans however still include Medicare Part B (doctor’s visits) coinsurance or co-payment, however Plan K only to 50%, and Plan L to 75%.
Skilled nursing facility care coinsurance is also not covered in some plans.
A few plans cover foreign travel health care emergency costs to 80%.
Costs/Premiums comparison of Medigap plans
Some Medigap plans have higher monthly premiums, but limit your out-of-pocket costs. Some plans have lower premiums, but require you to pay coinsurance. However, you are protected with an annual out-of-pocket limit.
Medigap plan G is currently the only supplemental policy sold that does cover costs known as ‘Medicare Part B excess charges’ (the difference between what a health care provider may charge and what Medicare will pay for outpatient services). In case you need treatment that exceeds the Medicare approved amount, Plan G will help shield you from unforeseen out-of-pocket expenses.
This is only a brief outline, a detailed overview of the different Medigap plans can be found at https://www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policies
What else to look for when selecting a Medigap plan
- Note that original Medicare Part A (Hospital insurance) and Part B (Outpatient insurance) are not the same as Medigap policies plan A or plan B.
- Keep in mind that no Medigap plan will provide prescription drug benefits, which means that you need to purchase a separate Part D plan (PDP) to help with your medication expenses.
- You also will not have dental and vision, or hearing aids coverage. If dental, vision or hearing aids are important to you, you will have to look for additional insurance.
- You may also check out whether selecting a Medicare Advantage plan may be a better option for you in lieu of Medigap.
- Make sure to compare rates from different insurance providers before deciding on any Medicare plan!
DISCLAIMER: As the information provided on this website may be incomplete, or incorrect, or have changed since this post was published, we urge you to consult with a Medicare professional to go over all your options, and help you find the best plan, at the best price, for your individual health care needs. To find a Medigap policy in your area, you may also check out Medicare.gov.
