Medicare Supplement (also called “Medigap”) is insurance that helps fill “gaps” in Original Medicare and is sold by private companies. Original Medicare pays for much, but not all of the cost for covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs, like Copayments, Coinsurance and Deductibles.
It is important not to confuse Medicare supplement Plan A and Plan B with Medicare Part A and Part B. Original Medicare includes Medicare Part A, which is inpatient hospital coverage, and Medicare Part B, which covers outpatient physician visits. Medicare supplement Plans A and Plan B are supplemental insurance to cover the costs Original Medicare leaves behind.
Some Medigap policies also cover services that Original Medicare does not cover, like medical insurance when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, coverage will work like following:
- Firstly, Medicare will pay its share of the Medicare-approved amount for covered health care costs.
- Then, your Medigap insurance company pays its share.
Medicare Supplement Plans
Medicare supplement plans are secondary payers to Original Medicare. Since Parts A and B do not cover 100% of healthcare expenses, Medigap helps you pay the remaining costs. As long as the provider accepts Medicare assignment, they will also accept a one of the Medicare supplement plans.
Medicare supplement policies generally don’t cover:
- Long-term care (like non-skilled care you get in a nursing home)
- Vision or dental services
- Hearing aids
- Eyeglasses
- Private-duty nursing
There are 10 Medicare supplement plans available, and 2 versions of High-deductible plans available in few states only. Each plan must be compared side-be-side to understand how one differ from another. There is a breakdown of plans in the table below.
Table 1: Medicare supplement plans
|
PLANS |
DESCRIPTION |
| PLAN A | It covers the 20% of outpatient medical care Traditional Medicare expects you to take care of. It also provides Medicare Part B coinsurance or copayment coverage |
| PLAN B | With Plan B, the Medicare Part A inpatient deductible is covered. |
| PLAN C | Plan C covers all benefits except the Part B excess charges |
| PLAN D | Plan D offers benefits for everything under Original Medicare, but does not pay for the Part B deductible or Part B excess charges. |
| PLAN F | It pays for all gaps in coverage by Original Medicare including your hospital and outpatient deductibles |
| HIGH DEDUCTIBLE PLAN F | Same as Plan F, but offers a lower premium in exchange for a higher deductible |
| PLAN G | It offers coverage for everything except the Part B deductible. |
| HIGH DEDUCTIBLE PLAN G | This plan is the same as Plan G, but offers a lower monthly premium in exchange for a higher deductible |
| PLAN K | Plan K only covers 50% of some of the benefits that other plans cover 100% of. It does not cover Part B’s deductible, excess charges, or a foreign travel emergency |
| PLAN L | Plan L only covers 75% of some of the benefits that other plans cover 100% of |
| PLAN M | Plan M only covers 50% of the Part A inpatient deductible and it does not cover the Part B deductible or the Part B excess charges |
| PLAN N | It has small copays, but covers everything else except the Part B deductible and Part B excess charges |
Thomas M. Brzezinski is one of the founding partners of WMAG William & Michael Advisor Group LLC and Jersey Insurance Solutions. He has been involved in the insurance industry for over ten years and specializes in developing client relationships that last a lifetime.
