Essential Guide to Comparing Medicare Supplement Plans

Medicare Supplement plans, commonly known as Medigap, are private insurance policies designed to cover healthcare costs not fully paid by original Medicare. These plans help pay for copayments, deductibles, and coinsurance, and some even cover medical services while traveling abroad. Essentially, Medigap acts as a supplement to Medicare, filling in gaps to reduce out-of-pocket expenses for beneficiaries.

When selecting a Medigap plan, remember that the original Medicare will still cover or pay its portion of approved healthcare costs. To obtain a Medigap policy, beneficiaries must already have both Medicare Part A and Part B. These plans require a monthly premium and are available in standardized plans labeled A through N, though plans E, H, I, and J are no longer offered to new enrollees. Premium costs may differ, but benefits are typically consistent across plans. Standard policies can vary slightly depending on the state, especially in Minnesota, Massachusetts, and Wisconsin.

The enrollment period begins at age 65 and lasts for six months, starting the first month of Medicare eligibility. Factors influencing premium prices include plan type, location, age, and insurer. All Medigap policies are renewable regardless of health status.

Comparison Highlights for Medigap Plans

• Hospital Coinsurance & Costs: Most plans cover costs associated with hospital stays beyond Medicare’s coverage, including copayments for days 61-90 and beyond, offering extra coverage for up to 365 additional days.
• Outpatient Coinsurance: Typically, Medicare covers 80%, leaving 20% to be paid by the beneficiary. Medigap often fills this gap.
• Blood Coverage: All plans cover the first three units of blood; Medicare covers additional blood needs at 100%.
• Hospice Care Coinsurance: Plans pay for some or all hospice copayments, with Medicare covering remaining costs.
• Skilled Nursing Facility: Medicare covers the first 20 days fully, with plans covering coinsurance from days 21-100 to help with rehab or skilled nursing needs.
• Deductibles: The Part A hospital deductible (e.g., $1,316 in 2017) and Part B outpatient deductible (e.g., $183 in 2017) are payable by beneficiaries, with some plans offering coverage options.
• Excess Charges & Foreign Travel: Certain plans cover excess charges from providers billing above Medicare-approved rates, and some policies include coverage for emergency care abroad, covering 80% up to $50,000.

Although Medigap plans are standardized, costs may vary significantly. Prospective buyers should compare options to find affordable coverage that best suits their needs.