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Medicare Supplement Insurance (Medigap)

Today, over 10 million Americans have Medicare Supplement Insurance in addition to Original Medicare. Also known as Medigap, these plans help you cover the expenses Medicare doesn’t, like coinsurance and deductibles.

No matter which US state you live in, you have access to this option—and it’s quite popular, since having a Medicare Supplement Plan means paying little to nothing for co-pays.

This is especially beneficial if you’re one of many people who was surprised to learn that Medicare only covers 80% of your Part B costs. That remaining 20% can be a devastating expense if you’re stricken with a serious illness.

Your Medicare Supplement Plan can cover some or all of the 20%. This policy can be a great way to get peace of mind and say goodbye to stressing over out-of-pocket expenses.

But perhaps the best thing is that during your open enrollment period, you’re legally guaranteed the right to this coverage. Your current health and pre-existing conditions aren’t a factor during this time.

In this guide, we’ll cover all the key points you need to know about Medicare Supplement Insurance, including:

  • How Medicare Supplement Plans help you cover the expenses Medicare doesn’t pay
  • The requirements you have to meet before you can purchase Medigap
  • The 10 different Medicare Supplement Plans available and how they’re standardized across insurance providers

What is a Medicare Supplement Insurance Plan?

A Medicare Supplement Insurance Plan helps pay some (or all) of healthcare expenses like the 20% of outpatient costs you’re expected to pay with Medicare. These plans were created to ease the pressure of paying out-of-pocket for medical visits.

Here are the main benefits of choosing a traditional Medicare Supplement Insurance Plan:

  • You’re free to choose any doctor or hospital you like
  • You don’t need a referral to see a specialist
  • Your Medicare-related out-of-pocket expenses will be predictable (or may be zero if you choose Plan F)
  • You can use your coverage anywhere in the US
  • By law, your insurance company can never deny you coverage or drop you as a member

All in all, Medigap is the most predictable option you can buy for back-end coverage. With one of these plans, you’ll know exactly what is and isn’t covered in regard to both your inpatient and outpatient procedures.

A few other things you should know about having a Medicare Supplement Insurance Plan:

  • You can’t buy one of these plans without enrolling in both Medicare Part A and Part B.
  • A Medigap plan only covers you—your spouse must enroll in their own policy.
  • You can elect to drop your plan anytime. Medicare Supplement Plans don’t have annual election periods.
  • While the Medicare annual election period occurs each fall, this window doesn’t apply to Medicare Supplement Plans.
  • Many insurance providers offer a household discount if two people (or more) enroll in a Medicare Supplement Plan from the same company.
  • Your plan won’t include Part D, which means you’ll need to buy a Plan D drug plan separately for prescription drug coverage.

What Your Medicare Supplement Plan Covers

The core idea to understand here is that your Medicare Supplement Plan covers what’s left after Original Medicare approves and pays its share of your medical claim. The reason this plan is called “Medigap” is that it fills the “gaps” left by Medicare. Medigap covers things like copays, coinsurance, and deductibles.

Your Medicare Supplement Plan can be used with any provider that accepts Medicare. If you travel often or live in more than one state annually, this plan can be a great option.

But know that your Medicare Supplement Plan doesn’t cover medications. You’ll need a separate drug plan (known as Part D) to help with these expenses. Also, this plan won’t cover routine vision, dental, or hearing services, just like how Medicare itself won’t cover these expenses.

Standardized Medicare Supplement Plans

Take a look at the chart below to understand all of the Medicare Supplement Plans available to you. We created this chart using Medicare’s handbook, and we update it annually.

This chart breaks down each plan in simpler terms than you’ll find in your Medicare handbook. If you still have questions, call (833) 331-2942 to speak with our insurance advisors.

Enrolling in a Medicare Supplement Plan

Barring special circumstances, it’s ideal to buy your Medicare Supplement Plan during your one-time six-month enrollment period. This window opens either the month you enroll in Part B or the first day of your birth month.

Throughout these six months, your Medicare Supplement Plan provider can’t ask you any questions about your health or pre-existing conditions. You’ll have full control over choosing the best Medigap plan for you, regardless of your current health.

Keep in mind that the annual election period for Medicare has no impact on your Medicare Supplement Plan. You have no right to guaranteed acceptance during this annual period each autumn.`

Your Guaranteed Issue Rights to Medicare Supplemental Plans

It’s quite common to delay enrolling in a Medicare Supplemental Plan when you have healthcare coverage through your employer. When you either lose that coverage or retire, you’re guaranteed the right to purchase certain Medigap plans within 63 days of your loss of coverage.

This is what the phrase “guaranteed issue rights” means regarding your Medicare Supplement Plan.

Your guaranteed issue window is very similar to open enrollment, except your window of eligibility is shorter, and you’re limited to Plan A, Plan B, Plan D, Plan G, Plan K, or Plan L (assuming you qualified after 2020). No matter which insurance company you choose, they can’t deny your application during your guaranteed issue enrollment period.

There are a few other circumstances where you’ll receive a guaranteed issue window, such as losing your Advantage plan when you move to a different state. Ideally, hold on to any and all notices from your insurance carrier to make your swap to Medigap easier.

If you’re worried about doing this correctly— or specifically about incurring the Part D late enrollment penalty—call us today at (833) 331-2942.

How Underwriting Works for Medicare Supplemental Insurance

Worried that you can’t get Medicare Supplemental Insurance because your open enrollment window has already closed? You still have options. The biggest difference is that once your window closes, you have to go through medical underwriting. 

Basically, insurance companies want to make sure you’re in good health before activating your policy. If you apply for a Medicare Supplement Plan after your window has closed, you’ll be required to answer questions about your health and pre-existing conditions.

The insurance company then gets to decide whether to accept your application. They can legally deny you, which is why it’s so important to utilize your open enrollment period for Medigap.

To be clear, the annual drug election period only applies to Part D of Medicare Advantage plans. During this time, you can’t freely switch your Medicare Supplement Plan. No matter when you opt to switch plans, you’ll have to go through medical underwriting.

We’ll Help You Find the Best Medicare Supplemental Insurance for Your Needs

Here’s a quick review of the key points you’ve learned in this guide:

  • Medicare Supplement Plans are designed to help cover out-of-pocket costs like deductibles.
  • You can choose from 10 standardized plans, with Plan F, Plan G, and Plan N being the most common.
  • Your Medicare Supplement Plan can be used with any provider that accepts Medicare.
  • Your one-time open enrollment period is triggered by your Part B activation, and during this time, you won’t have to answer any health questions.

But you should also know that buying your healthcare coverage directly from the insurance company isn’t always the best value for your money. When you purchase through our advisors here at Family First, you get FREE additional services anytime, such as:

  • Clear explanations of Medicare and what your basic benefits are
  • Detailed quotes from the nation’s leading insurance companies
  • Trend-rate history reports so you can see which companies have the lowest rate increases
  • Financial rating reports for each insurance company
  • Yearly assistance with rate shopping so you always pay the lowest amount possible
  • Claims support and personal assistance if Medicare denies your claim
  • Access to our full-time Support Team to answer all your Medicare questions
  • Exclusive invite to our annual autumn webinar on upcoming changes to Medicare

Get in touch with our advisors today to get more information and start comparing quotes from companies in your local area. Just call us now at (833) 331-2942 to get started!

FAQs About Medicare Supplement Insurance Plans

What are all the different Medicare Supplement Plans available to me?

You can refer to the chart above to see the 10 different Medicare Supplement Plans, which are each labeled with a letter (A through N). Every letter includes a different, specific set of benefits.

No matter which insurance company you choose, they have to offer the benefits included with that specific plan. So, Plan N from United Healthcare has the same benefits as Plan N from Blue Cross Blue Shield.

But keep in mind that Massachusetts, Minnesota, and Wisconsin have different statewide options.

There’s one plan you can choose that covers ALL gaps, meaning you pay nothing out-of-pocket. This is Plan F. Other plans, like Plan G and Plan N, have a lower monthly premium, but include out-of-pocket expenses.

Get in touch with us at Family First today to discuss which Medicare Supplemental Insurance Plan best suits your needs.

How do I choose a Medicare Supplement Plan?

The vast majority of people choose Plan F, Plan G, or Plan N as their Medicare Supplement Plan. This is because you get the most coverage from these three options. But ultimately, you have to choose what works best for you—which may be different than what your neighbor or friend chooses.

Think about whether you’d rather pay a lower premium in exchange for covering some costs out-of-pocket, or whether it’s worth a higher premium for that peace of mind. When you call us, we’ll ask simple questions to help you arrive at the best choice.

What’s the absolute best Medicare Supplement Plan?

Right now, Medicare Supplement Plan F offers the highest amount of coverage. This plan covers all cost-sharing related to Medicare, which means you pay nothing for covered services.

You can purchase your Medicare Supplemental Insurance from one of many insurance providers. Remember, your plan’s benefits will be identical no matter which company you choose— Plan F is the same no matter who you get it from.

Plan G would be the second-most comprehensive. Unlike Plan F, you’ll have to pay your Part B deductible once annually. In exchange, you pay lower premiums, which can lead to savings year over year.

What’s the average cost of a Medicare Supplement Plan?

The average cost of a Medicare Supplement Plan varies quite a bit depending on what state you live in.

Florida, for example, has higher premiums because healthcare services cost more in that part of the US. But the same plan in Texas could cost a healthy individual half the price they’d pay in Florida.

Other details matter too, like your age, address, gender, and whether you use tobacco. To get personalized quotes for your Medicare Supplement Plan, call us at (833) 331-2942.

How does the open enrollment period for Medicare Supplemental Insurance work?

When you first activate your Medicare Part B coverage, you have six months to enroll in Medicare Supplemental Insurance—no questions asked. Said another way, any pre-existing conditions won’t impact your eligibility during this time.

But this is a one-time opportunity. Once the six months are over, your Medicare Supplemental Insurance open enrollment period is permanently closed. In most cases, changing your Medicare Supplemental Insurance after this enrollment period is difficult.

Can I change my Medicare Supplement Plan anytime?

You can technically apply to change your Medicare Supplement Plan anytime, but there’s no guarantee your request will be approved.

In most states, you’ll first have to answer questions about your health and current medications. Then, the insurance company gets the final say on whether you get to make the change.

The exceptions to this rule are California, Connecticut, Oregon, and Washington, which have different rules.

What does “guaranteed issue” mean in relation to Medicare Supplemental Insurance?

In relation to Medicare Supplemental Insurance, “guaranteed issue” means your right to get insurance coverage regardless of your current health. These rights apply in certain circumstances, such as if you’re on Medicaid but lose eligibility.

You also have guaranteed issue rights if you swap your primary coverage from your employer’s plan to Medicare. You’ll have a brief window to apply for your Medigap plan in this scenario.

Am I going to need a Medicare Supplement Plan?

A Medicare Supplement Plan is entirely optional, but not buying one can get expensive fast. You’ll be responsible for all your hospital copays and deductibles, plus 20% of the cost of all your outpatient services.

This includes chemotherapy, surgeries, and other expensive procedures that could be financially devastating if you have to cover everything yourself.

But we understand that a Medicare Supplement Plan just isn’t in the budget for many people. If this describes you, consider a Medicare Advantage plan instead. This option gives you lower premiums because you promise to work with specific providers in your local area.