Medicare Supplement plans are insurance plans designed to fill the gaps of original Medicare. They are often called “Medigap” plans.
These medicare supplement insurance plans designed to fill in the gaps of original Medicare. Medicare Supplement plans don’t replace original Medicare the same way that Medicare Advantage Plans do. But they also generally don’t give benefits that original Medicare doesn’t offer. Unlike Medigap Plans, Medicare Advantage Plans usually offer additional benefits.
For example, a Medicare Advantage Plan might include dental, vision, or hearing benefits. It might include transportation costs or even food after a hospital stay. Medicare Supplement Plans do not include these extra benefits.
Although Medigap plans are generally more expensive on a monthly basis than Medicare Advantage Plans, they can actually cost less over the course of a year depending on your circumstances.
For example, if you needed chemotherapy, many Medicare Advantage Plans will have a copay of 20%. This can be quite expensive, and often results in you hitting the Maximum out of Pocket or MOOP. In 2020 the highest MOOP a plan can have for an HMO is $6,700.
Let’s say you live in Florida. Let’s say that you are 75 years old. You could be paying a premium of $224.49 with a major insurance company. That’s a total of $2,693.88, far less than the MOOP you would have had to pay on the MAPD plan.
Why is this? Because the Supplement Plan F covers your Medicare copays and deductibles at 100%.
Of course you’ll still need a drug plan, but they are often very inexpensive. It’s the cost of your drugs that you need to worry about with drug plans.
Why do I need a Medicare Supplement Plan?
The answer is pretty obvious. In the scenario above, you would have had to pay a bundle for chemotherapy, with either original Medicare (the copay is 20% with NO CAP) or an MAPD plan (the copay is often 20% with a cap-the MOOP).
Some people forgo getting a Medigap or a Medicare Advantage Plan, but this could be a big mistake.
Medical costs NOT covered by Medicare, such as deductibles and copayments, can be quite high. That’s why you should consider purchasing a Medicare Supplement Plan.
If I lived on the east coast, I’d make sure I had hurricane insurance. If I lived in California, I’d have earthquake insurance. Insurance is designed to control the costs that could wipe you out. And having a potential unlimited liability (as you have with original Medicare) can wipe you out.
What does Medicare Supplement Insurance Cover?
Because Medicare doesn’t cover at 100%, you must pay a portion of your medical expenses. Your portion includes deductibles, co-payments, and excess charges. An excess charge occurs when doctors accept original Medicare Part B, but they do not accept assignment. When this happens they can charge you an additional 15% over the Medicare approved rate.
Some booklets indicate that Medicare Supplement Plans cover items not covered by Medicare. But personally, I think it’s misleading. Medicare Supplement plans typically don’t cover services that original Medicare doesn’t cover.
I’ll give you an example. Medicare doesn’t cover hearing aids. So because of that, your Medicare supplement plan won’t cover it either, unless it’s an Innovative or “Extra” plan. Ask your broker if you have access to one of these plans.
Does the ACA guarantee me the right to buy a Medicare Supplement plan?
The ACA doesn’t guarantee you the right to purchase a Medicare Supplement Plan. However, you still might have a guaranteed right now buy one.
It depends on when you purchased the plan. There is a time period when a company must sell a Medicare Supplement policy to you. This six-month period is generally called “Medigap Open Enrollment.” Open Enrollment begins when you are 65 or older and enroll in Medicare Part B.
During this Open Enrollment period an insurance company must sell you certain Medicare supplement policies, regardless of your health, if they operate in that state.
And the company cannot refuse to cover your medical conditions during this time period either. Because of that, I believe that open enrollment is the best time to obtain a Medigap plan.
There are other time periods called “Guaranteed Issue” or GI periods. However, because agents and brokers often don’t get paid during these time periods (but have risk associated with taking you on as a client) you’ll likely not hear a lot about these GI periods.
How much do Medicare Supplement Plans cost?
This question is not that easy to answer because each insurance company sets their own rates. You can find out how much these plans cost by running a free quote for yourself. You won’t have to enter your email address or phone number, it’s completely free. Just go to Free Medigap Quote.
And if you want to learn more about Medicare, check out MedicareQuick.com. You’ll be glad you did.
