Medicare Supplement Plans - The Insurance Pros

Medicare Supplement plans, also known as Medigap, are designed to help cover some of the costs that Original Medicare (Part A and Part B) doesn’t cover, like copayments, coinsurance, and deductibles. 

Plan A

• Covers the basics: Part A coinsurance and hospital costs, Part B coinsurance or copayment, the first 3 pints of blood for a transfusion, and Part A hospice care coinsurance or copayment.

Plan B

• Includes everything in Plan A, plus coverage for the Part A deductible.

 Plan C 

• Covers all the benefits in Plan A and B, Part A deductible, Part B deductible, Part B excess charges (extra charges providers may charge if they don’t accept Medicare assignment), and foreign travel emergency coverage.
• Note: New Medicare enrollees after 2020 can’t enroll in Plan C.

Plan D

• Covers everything in Plan A and B, plus the Part A deductible and foreign travel emergency coverage.
• Does not cover the Part B deductible, unlike Plan C.

Plan F 

• Offers the most comprehensive coverage, covering everything from Part A and B coinsurance to the Part A deductible, Part B deductible, Part B excess charges, and foreign travel emergency.
• Note: New enrollees after 2020 cannot purchase Plan F.

Plan G

• Provides all the benefits of Plan F, except it does not cover the Part B deductible.
• It’s one of the most popular Medigap plans because it’s comprehensive and generally more affordable than Plan F.

Plan K

• Covers 50% of most services (like Part A coinsurance and Part B coinsurance), the Part A hospice care coinsurance/copayment, and three pints of blood.
• Has an annual out-of-pocket limit (after which the plan pays 100% of covered services).

Plan L

• Covers 75% of most services, similar to Plan K, but with a higher coverage level. Also has an annual out-of-pocket limit.

Plan M

• Covers everything from Plan A and B but only covers 50% of the Part A deductible.
• Also has foreign travel emergency coverage.

Plan N

• Covers most of the same things as Plan G, but with a small copayment for doctor visits (up to $20) and emergency room visits (up to $50), and does not cover Part B excess charges.

Things to remember:

• Plan F and Plan C are now only available to those who were eligible for Medicare before 2020.
• Plan G has become the most popular Medigap plan for new enrollees, as it offers comprehensive coverage without the high cost of Plan F.
• Plans K and L have annual out-of-pocket limits, which can help with budgeting for healthcare costs.

It’s always a good idea to compare the different plans to find the one that works best for your needs and budget. 

Comprehensive Coverage

Fills gaps in Medicare:

• Medigap plans help cover costs that Original Medicare doesn’t, like deductibles, coinsurance, and copayments.
• Predictable costs: Many Medigap plans provide comprehensive coverage, meaning you won’t be faced with high out-of-pocket costs for things like hospital stays or doctor visits, especially with plans like F or G.

Freedom of Providers

• No network restrictions: Medigap plans generally don’t have networks. As long as the provider accepts Medicare, you can see any doctor or specialist who participates in Medicare, even if they are outside your local area.

Stable Premiums

• Predictable monthly premiums: Medigap plans are sold by private insurers, and your premium is generally fixed and doesn't change depending on your usage (unlike some other plans that might adjust based on how much you use the service).
• No referrals needed: You don’t need a referral to see specialists.

International Coverage

• Some Medigap plans (like Plan C, Plan D, Plan F, and Plan G) offer emergency foreign travel coverage—a big perk if you travel abroad frequently.

Guaranteed Renewal

• No age-based premiums: As long as you pay your premium, the insurer cannot drop you from the plan due to illness or age. This provides peace of mind if you have ongoing health issues.

Lifetime Coverage

• Unlike some private insurance plans, Medigap covers you for life, so as long as you keep paying your premiums, you will have coverage.

Additional Monthly Premium

• Separate premium from Medicare: In addition to paying your Medicare Part B premium, you’ll pay a monthly premium for your Medigap plan. This can add up, especially if you choose a more comprehensive plan like Plan G or Plan F (for those eligible prior to 2020).
• Premiums vary by insurer, location, and plan type, so it’s important to shop around to find the best value.

No Prescription Drug Coverage

• No drug coverage: Medigap plans do not include prescription drug coverage (Part D). You’ll need to enroll in a separate Part D plan if you want prescription coverage.

Limited Enrollment Period

• Initial Enrollment Period is critical: You can only buy Medigap during your Medicare Initial Enrollment Period (the 6 months after you turn 65 and are enrolled in Part B) when you are guaranteed acceptance. If you miss this period, insurers can deny you coverage or charge you higher premiums based on your health history (unless you have a special enrollment period).

Not All Plans Available in All States

• The availability of specific Medigap plans can vary by state. For example, Plan C and Plan F are no longer available to new Medicare enrollees as of 2020. Some states also have different rules for how Medigap plans are offered.

No Coverage for Long-Term Care

• Medigap does not cover long-term care (nursing home care, custodial care, etc.) or care for chronic conditions. If you need long-term care, you would need a separate policy, like long-term care insurance.

Doesn't Cover All Medicare Cost

• While Medigap plans cover a lot, they don’t cover everything. For example, they don’t cover Part D prescription drugs, vision care, dental care, or hearing aids.

Can Be Expensive in Some Areas

• Costs vary by location: The cost of Medigap plans can vary significantly depending on where you live. In some areas, premiums may be relatively low, but in other areas, they can be quite high, especially for comprehensive plans like Plan G.

Premiums Can Increase Over Time

• Even though Medigap premiums are stable, they are subject to increase over time, typically due to inflation, age, or other factors. Insurers can raise premiums based on your age (community-rated vs. issue-age-rated plans), so costs can increase as you get older.

Medicare Supplement Plans offer comprehensive coverage, predictable costs, and the flexibility to see any Medicare-accepting doctor or specialist. It’s a solid choice for those who want to minimize their out-of-pocket expenses and have a more stable, reliable plan. However, like all health insurance plans, there are a few drawbacks. The major drawbacks are the additional premium cost (on top of Medicare), the lack of prescription drug coverage, and the limited enrollment window. Also, if you’re expecting long-term care or dental/vision coverage, Medigap won’t provide that.

At The Insurance Pros, we represent several different companies that offer all types Medicare Supplement Plans. Having a variety of carriers allows us to shop around and find the best price and fit for you. Some of our Medicare Supplement carriers include Blue Cross Blue Shield of AL, Aetna, UnitedHealthcare, Mutual of Omaha, and more. Give us a call today to learn more!

Medicare.gov 

Centers for Medicare and Medicaid Services