Priscilla Wright

(657) 205-1081

Medicare Supplement Plans (Medigap)

Medicare Supplement plans cover 10 million Medicare beneficiaries. Also referred to as Medigap plans, these policies help pay for your share of Medicare expenses, such as your deductibles and co-insurance. Medicare supplement insurance plans are available for purchase in all 50 states and are very popular with people who want little to no copays when they access healthcare services.

Many people new to Medicare feel surprised to find that Medicare covers only 80% of your Part B expenses. The other 20% can be devastating to you financially if an unexpected serious illness arises. Medicare Supplements pay that 20% for you, among other services. Supplemental insurance for seniors with Medicare essentially buys you peace of mind by eliminating that cost-sharing responsibility.

"My goal is to find the best Medicare Supplement and Medicare Advantage plan that suits your needs." - Priscilla Wright

What is Medicare Supplemental Insurance?

Medicare supplements came into being shortly after Medicare was signed into law. Because you are required to pay for some things, like 20% of outpatient expenses, supplemental policies were created to pay those expenses for you. This allows people to feel less worry over how much each medical visit will end up costing them.

Some of the primary advantages of a traditional Medicare supplement policy are:
•Freedom to choose your own doctors and hospitals
•No referrals required to see a specialist
•Predictable out-of-pocket expenses for Medicare-covered services (and zero out-of-pocket with Plan F)
•Nationwide coverage – you can use it anywhere in the United States
•Guaranteed renewability – the insurance company can never drop you or change your coverage due to a health condition
•No claims paperwork – Medicare supplement companies have crossover filing with Medicare. When your provider files a claim with Medicare, that claim is automatically filed with your supplement company too

Supplemental insurance for seniors with Medicare is the most predictable back-end coverage that you can buy. You will know exactly what’s covered for every inpatient or outpatient procedure based on which Medigap plan you choose.

Some other things to know about Medicare Supplement insurance:

•You must have Part A and Part B to buy a Medigap policy.
•Medicare supplement plans cover only one person. Your spouse must have his or her own individual policy.
•You can drop your supplement at any time. There is no annual election period for Medicare Supplement plans.
•The annual election period in the fall is for drug plans. It does not apply to Medicare supplements in any way.
•Many carriers offer household discounts if two or more people enroll in Medicare supplemental plans from the same company.
•Plans do not include Part D, so you’ll add a separate standalone Part D drug plan.

Medicare Supplemental Plans Coverage

Medicare Supplement plans pay after Medicare approves and pays its share of your claim. They are Medicare gap insurance, helping to cover the gaps in Medicare that normally you would have to pay. This includes things like deductibles, coinsurance and copays.

You can use your Medicare Supplement plan at any provider in the nation that accepts Medicare. This makes Medicare supplements great for travel or for people who live in more than one state throughout the year.

Medicare Supplements plans do not include retail drug coverage, so you’ll want to purchase a standalone Part D drug plan for your medications. A Medicare Supplement does not cover routine, dental, vision or hearing services either. Since Medicare itself does not cover these items, so your supplement cannot pay anything toward them either.

Choosing a Medicare Supplement

Since Medigap plans are standardized, you will know exactly which benefits you are purchasing. There are several factors which you will want to know about each insurance carrier before you choose your supplement though:

Rates – What is a Medicare supplement premium? It’s the monthly rate that you pay to the insurance company that provides your Medicare Supplement coverage? Find out what premium each insurance carrier will charge you. Are they offering a low premium? Is it competitive with other Medigap insurance companies in your area?

Rate trend historyMost policies will have an annual rate increase to keep up with medical inflation. What kind of rate increases has the carrier you are considering had over the last 3 years? Are the rate increases reasonable or significantly higher than the competitors?

Elderly Man and His Friends

Financial ratings – A number of ratings companies dig into the financial stability of each insurance carrier. These companies give reports, or grades, on the fiscal health of the insurer. Ask your agent what the A.M. Best and Weiss Ratings are for each carrier. Then consider this information when making your selection.

Get a personalized analysis of which Medigap insurance carrier offers the best pricing, financial rating and rate trend history. Request quotes here.

What is Not Covered by Medicare Supplement Plans?

Medicare supplements only pay after Medicare has first paid its share. If Medicare approves a claim and pays the part that Medicare owes, it will forward the remainder of the bill to your Medicare Supplement.

Some things that are not covered by Medicare or your Medicare Supplement are:
•Routine dental, vision and hearing exams
•Hearing aids
•Eyeglasses or contacts
•Long-term care or custodial care
•Retail prescription drugs

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Medicare Supplements Plans – Standardized Plans

To see a list of all the Medicare supplemental plans available – take a look at our Medigap supplement chart below. This chart appears in the “Choosing a Medigap,” booklet published by Medicare itself. It details the benefits covered by each different plan.

Some of our clients have found Medicare’s handbook hard to read, so here on our site, we’ve tried to use simpler terms. Our pages about the different Medicare supplements include examples of how the coverage would pay. This will help you understand how they work in real situations.

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