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Medicare Supplement (Medigap) Insurance

Medicare Supplement, or Medigap, plans fill in the gaps in coverage left behind by Original Medicare, such as deductibles, coinsurance, and copayments. In 47 states, there are 10 standardized Medigap plans that are denoted by the letters A through N. The private insurance companies offering these plans do not have to offer every Medigap plan, but they must offer at least Plan A and either Plan C or Plan F if they choose to offer any supplemental coverage.

Medicare Supplement Plan Coverage

Medicare Supplement plans each offer different levels of coverage, but each lettered plan must include the same standardized benefits regardless of carrier and location. For example, Plan F in Florida includes the same benefits as Plan F in North Dakota. Please note that, if you live in Massachusetts, Minnesota, or Wisconsin, your Medicare Supplement Insurance options are different than in the rest of the country. Medicare Supplement plans do not cover vision, dental, long-term care, or hearing aids, but all plans do cover the following basic benefits:

  • Medicare Part A coinsurance costs up to an additional 365 days after Original Medicare benefits are exhausted
  • Medicare Part A hospice care coinsurance or copayments
  • Medicare Part B coinsurance or copayments
  • First three pints of blood used in a medical procedure

Plans that include additional coverage, such as Plan F, may also offer a variation of the following additional benefits:

  • Medicare Part A deductible
  • Medicare Part B deductible
  • Part B excess charges
  • Part B preventive care coinsurance
  • Skilled Nursing Facility (SNF) care coinsurance
  • Foreign travel emergency care

Medicare Supplement Plan Costs

Although private insurance companies are required to offer the same benefits for each lettered plan, they do have the ability to charge higher out-of-pocket costs for this coverage. Therefore, it is recommended that beneficiaries shop around to find a Medicare Supplement plan that is right for both their medical and financial needs. Out-of-pocket costs associated with Medicare Supplement plans may include monthly premiums and yearly deductibles. Plans may price their plan premiums in the following ways:

  • Community no-age-rated: These plans require premiums that are the same across the board, regardless of age.
  • Issue-age-rated: These plans base their premiums on the age you were when you first enrolled in the policy. Therefore, the younger you are when you enroll in this type of plan, the lower your premium will be.
  • Attained-age-rated: Like issue-age-rated, these plans base their premiums on the age you were when you first bought a policy, but unlike issue-age-rated, premiums increase as you get older.

Medicare Supplement Plan Enrollment and Eligibility

To be eligible to enroll in a Medicare Supplement plan, you must be enrolled in both Medicare Part A and Part B. The best time to enroll in a plan is during the Medigap Open Enrollment Period, which begins on the first day of the month that you are both age 65 or older and enrolled in Part B, and lasts for six months. During this period, you have the guaranteed issue right to join any plan of your choice, meaning that you may not be denied coverage based on any pre-existing conditions. If you miss this enrollment period and attempt to enroll in the future, you may be denied coverage based on your medical history.

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