What Is Medicare Supplement Insurance?
If you want to supplement your Medicare Part A (hospital care) and Medicare Part B (medical care) coverage, you may be able to buy a supplemental insurance plan from a private insurance company. Medicare Supplement (also called Medigap) insurance plans may include basic benefits such as copayments, coinsurance, and deductibles not covered by Original Medicare (Part A and Part B). You will have to pay a monthly Medicare Supplement premium out-of-pocket in addition to your Medicare Part B premium. Medicare will not pay any of the costs of your Medicare Supplement insurance plan.
Supplemental insurance: Medicare Supplement insurance plans
A Medicare Supplement insurance plan is meant to work alongside Medicare Part A and Part B, not replace them. If you have Original Medicare and a Medicare Supplement insurance plan, generally Medicare will pay its share of Medicare-approved amounts for covered health-care costs and then your Medicare Supplement insurance plan will pay its share.
Keep in mind that:
- You typically need to pay your Medicare Part A or Part B deductible before Medicare covers most services. Some Medicare Supplement insurance plans may pay for one or both of these deductibles.
- Even if your Medicare Supplement insurance plan’s basic benefits include a certain Medicare out-of-pocket cost, the plan may not pay 100% of the cost. The Medicare Supplement insurance plan may reduce, not eliminate, your out-of-pocket costs.
- Medicare Supplement insurance plans can only be combined with Original Medicare (Plan A and Plan B), not Medicaid, Medicare Advantage, TRICARE, or employer/union group health coverage.
Supplemental insurance: 10 types of Medicare Supplement insurance plans
Medicare Supplement insurance plans are standardized, meaning that all insurance companies must offer the same benefits for the same plan. Up to 10 plans, labeled A, B, C*, D, F*, G, K, L, M, and N, are offered in most states (not Massachusetts, Minnesota or Wisconsin – they have their own standardized plans). Keep in mind that the same insurance plan sold by different companies may have different costs.
If an insurance company offers any Medicare Supplement insurance plan, it must make Plan A available. Plans E, H, I, and J are no longer sold.
Supplemental insurance basic benefits: how Medicare Supplement insurance plans can help
Basic benefits for all ten standardized Medicare Supplement insurance plans generally include Medicare Part A coinsurance and hospital costs at 100% (up to an additional 365 days after Medicare benefits are used up). Beyond this one benefit, basic benefits related to Medicare out-of-pocket costs vary among plans. All ten standardized insurance plans may pay for at least part of Medicare Part B coinsurance, the first three pints of blood for a medical procedure, and Part A hospice care coinsurance. Plans A, B, C*, D, F*, G, M and N may pay these three benefits at 100%. Plan K may pay them at 50% and Plan L may pay them at 75%. There are five other basic benefits that some plans include and some do not. These benefits are: skilled nursing facility care coinsurance, Part A deductible, Part B deductible*, Part B excess charges, and foreign travel emergencies (80% up to plan limits).
*Medicare Supplement plans that may cover the Medicare Part B deductible will eventually be discontinued. This change affects Plans C and F (including high-deductible Plan F). You won’t be able to buy Plan C or Plan F if you qualify for Medicare on January 1, 2020 or later. You don’t have to give up Plan C or Plan F if you already have one. If you qualify for Medicare by the end of 2019, you may be able to buy one of these plans. A high-deductible Plan G might become available in 2020.
In general, Medicare Supplement insurance plan basic benefits do not include routine dental or vision care, long-term care in a nursing home, hearing aids, eyeglasses, or private-duty nursing. However, some plans might include such additional benefits. Medicare Supplement insurance plans sold currently don’t include prescription drug coverage. If you need prescription drug coverage, you may want to enroll in a prescription drug plan through Medicare Part D.
Another type of Medicare Supplement insurance plan is Medicare SELECT. Medicare SELECT insurance plans might cost less than other plans but may limit you to in-network providers.
You might be able to find a Medicare Supplement insurance plan that meets your needs. To get started, enter your zip code in the box on this page.
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