So, who needs a Medigap Insurance? If you have Original Medicare, a Medicare Supplemental plan (also called Medigap or MedSup for short) can be a smart choice. It helps cover the costs that Medicare doesn’t, so you won’t have to worry about big medical bills. Learn more here.
Who Needs Medigap Insurance?
Planning for retirement can be stressful. One important decision is whether or not to get Medigap insurance. If you’re on Original Medicare and want to protect yourself from high out-of-pocket costs, MedSup is a great option.
Medigap is supplemental insurance that helps cover costs Original Medicare doesn’t pay. It can cover things like coinsurance, copayments, and deductibles. Those without Medigap usually have to pay 20% or more of the costs of procedures and could end up paying $1000’s out of pocket. Having just Medicare Part A and Part B puts you at serious financial risk that Medigap and, to a lessor extent, Medicare Advantage can address.
So who needs Medigap? We believe anyone who doesn’t have additional coverage through work, retirement, or the VA, should get a Medigap plan (or at least a Medicare Advantage plan).
Get a Medigap Quote Enroll in Medigap
While Medicare Supplement Insurance reduces your out-of-pocket expenses, it doesn’t cover everything. Medigap doesn’t cover prescription drugs, so you’ll need a separate Medicare Part D plan. It’s important to understand what each plan covers before making a choice, as benefits vary slightly by plan. (Source: Medicare.gov). Most people we work with here at Senior65.com select Medigap plan G, N, or High Deductible G.
What are the different Medigap plans and what do they offer?
One of the best things about Medigap is that the plans are pretty much the same nationwide (with the exception of Wisconsin, Minnesota, and Massachusetts). So, a Plan A in Florida is the same as a Plan A in Texas. You’ve got 10 basic plans to choose from, each with its own benefits. Let’s break it down for you:
| Benefits | A | B | D | G | K | L | M | N |
|---|---|---|---|---|---|---|---|---|
| Medicare Part A Deductible ($1,676) | 100% | 100% | 100% | 50% | 75% | 50% | 100% | |
| Part B Deductible ($257) | ||||||||
| Medicare Part A Hospital Coinsurance and 365 additional hospital days | 100% | 100% | 100% | 100% | 100% | 100% | 100% | 100% |
| Medicare Part B Coinsurance | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| First 3 Pints of Blood for a Transfusion | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Medicare Part A Hospice Coinsurance or Copay | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Skilled Nursing Facility Coinsurance | 100% | 100% | 50% | 75% | 100% | 100% | ||
| Medicare Part B Excess Charges | 100% | |||||||
| Foreign Emergency Healthcare | 80% | 80% | 80% | 80% | ||||
| Max Out-of-Pocket | $7,200 | $3,610 |
*Medigap Plan G High deductible ($2,870) is also available. Note: Plan F and Plan C are not featured on this chart as they are no longer available to those new to Medica
What’s the best Medigap plan for me?
Choosing the best Medigap plan can be tricky because it really depends on your unique situation. There’s no one-size-fits-all answer. To find the perfect Medigap plan, you’ll want to consider a few things:
- Your health history: If you’ve got some pre-existing conditions or you go to the doctor a lot, you might want a plan with more coverage.
- Your current medical costs: Look at how much you’re spending on medical bills that Medicare doesn’t cover.
- Your budget: Compare the monthly premiums for different plans. (Compare plans with our online quote here)
- The specific benefits you need: Some plans cover things like home visits or durable medical equipment that others don’t.
If you want the most coverage, Plan F was historically the best choice. It covered everything after Medicare paid its share. However, it’s no longer available to new enrollees since 2020. For those eligible after that, Plan G is the next best option. It covers almost everything Plan F does, but you’ll need to pay the Part B deductible yourself. Still, many people find the savings worth it.
Get a Medigap Quote Enroll in Medigap
When is the best time to enroll in a Medigap plan?
The best time to enroll in a Medigap plan is during your Initial Enrollment Period (IEP), AKA Open Enrollment Period (OEP). This is a six-month window that starts on the first day of the month you turn 65 and enroll in Medicare Part B.
During your IEP, insurance companies cannot deny you coverage or charge you more based on your health history. This is known as guaranteed issue. Once this period ends, you may have to go through medical underwriting, which could result in higher premiums or even denial of coverage. Feeling overwhelmed by deadlines? Let our Senior65.com Deadline Calculator take the load off.
There’s a few things you can do if you miss the Medigap deadline during your initial enrollment period. Read more in our complete article: What if I Miss My Medigap Deadline?.
Medigap and Medicare Advantage: What’s the Difference?
Medigap and Medicare Advantage are both private options, but they serve different purposes. MedSup works with Original Medicare, filling gaps by covering things like co-pays and deductibles. Medicare Advantage is an alternative to Original Medicare, combining Parts A and B, sometimes Part D, and often extra benefits like dental or vision. Medigap lets you see any provider who takes Medicare, while Medicare Advantage may have network restrictions.
Sure, the cost is different. But let’s dive deeper into the benefits. Read our article ‘Why would someone select Medigap over Medicare Advantage?‘ to help you decide.
Time for the next step!
With the basics down, grab a free Medigap quote and enroll now. Got any questions? Call us anytime at 800-930-7956. Remember, our help is completely free!