Medicare Supplement Plans

Every Medicare Supplement (Medigap) plan helps with some of the out-of-pockets costs that Original Medicare does not pay. Here are some examples

Predictable Out-of-Pocket Costs

Low or no out-of-pocket copay, coinsurance, or deductible plan options available. Choose any doctor or hospital that accepts Medicare patients—no referrals needed. Guaranteed Coverage for Life* Coverage is good anywhere in the United States

Medicare Supplements offer up to $50,000 in foreign travel emergency benefits (up to plan limits). Plan features stay the same from year to year, and your coverage will never change, even if your health does.

A Prescription drug (Part D) plans work with Medicare Supplement plans to provide you with more complete coverage.

Medigap Plan A

Medicare Plan A is the most basic Medicare Supplement. Medicare Supplement Plan A is also referred to as Medigap Plan A. This plan is sometimes overlooked because it has fewer benefits than other Medigap insurance plans.

Medigap Plan B

Medicare Supplement Plan B, also called Medigap Plan B, offers the same benefits as Plan A. In addition, it will also pay your Part A hospital deductible for you. This is a significant benefit as the Part A deductible is over $1,500 and tends to go up slightly each year. To see this year’s deductible, GO TO MEDICARE.GOV. Having Medigap Plan B means that you will never have to worry about that deductible going up. Your hospital deductible is a per-incident deductible, not an annual one, so this is an important benefit. Medicare Plan B will pay the deductible even if you incur it more than once in the same year.

Medigap Plan C

Plan C is a policy which covers all the Medicare gaps you would usually be required to pay. The only exception is the Part B excess charges. People eligible to apply for Plan C are those who became Medicare-eligible before January 1, 2020. Doctors and other healthcare providers can choose whether to participate in Medicare. Providers who participate with Medicare agree to charge you only the Medicare-approved amount for their services.

What Are Excess charges?

When a provider accepts Medicare assignment rates, it means that provider won’t bill you above the Medicare-allowable rate by a participating provider. Providers who don’t participate in Medicare can bill you up to 15% more than the Medicare allowable amount at their discretion. This additional amount is considered a Part B excess charge. You will have to pay it out-of-pocket unless you have a Medigap plan that includes benefits for Part B excess charges.

There are other advantages to choosing a participating provider, aside from avoiding Part B excess charges, if you have Medicare:

  • They agree to collect only your Part B deductible and/or coinsurance amount at the time of service. Most wait until Medicare has paid its share to bill you. Nonparticipating providers can collect payment in full upfront.
  • They must submit your claim to Medicare for you and at no cost to you. Nonparticipating providers, on the other hand, may not bill Medicare, so you have to file a claim yourself to get reimbursed.
  • 20% coinsurance plus the 15% Part B excess charge.

Note that excess charges do not go towards your Part B deductible.

Not all nonparticipating providers will add Part B excess charges if you don’t have a Medigap plan, so you may only rarely see Part B excess charges.

There is no limit on the number of times a nonparticipating doctor can add excess charges to your bill. So, if you regularly see a provider who does not accept assignments, you could easily pay hundreds of dollars in excess charges each year.

Also, if you see a doctor who accepts Medicare assignment, but Medicare does not accept the claim for the service billed, the doctor can charge you more than Medicare’s approved price. However, if an Advance Beneficiary Notice (ABN) isn’t signed, you may not be responsible for these charges. Note that ABNs are not required for services never covered by Medicare.

Medigap Plan D

A Medigap Plan D policy covers most of the gaps in Medicare for you, except for the Part B deductible and any excess charges. An excess charge is an additional amount you will pay if a provider charges more than the Medicare allowed amount. You will pay out-of-pocket for these items if you purchase a Medicare Plan D. However, the policy DOES cover all the most important things, like the 20% of outpatient services that you would otherwise owe. It’s important to compare pricing between Medigap Plan D and Plans F or G, which have richer benefits. This will help you determine if the savings is worth the additional financial exposure to you. Some people will rather pay more for their Supplement if they know that all the gaps will be covered. Others don’t mind a little cost-sharing to get lower premiums.

Plan F is now only available to those eligible for Medicare before January 1, 2020.

If you became eligible for Medicare on or after January 1, 2020, you would find that Plan G is the most comprehensive Medigap plan available to you. (In recent years, Plan G has been the second most popular Medicare Supplement plan, and you can read more on that below.)

A Medigap plan, or Medicare Supplement, pays after Medicare to help cover your deductibles, copays, and coinsurance that you would otherwise be responsible for. Medigap plans do not replace your Medicare Part B. You must be enrolled in both Part A and Part B first, then you are eligible to enroll in Medicare Supplement Plan F.

When you add a Medicare Supplement Plan F or G to your Original Medicare benefits, your coverage will be quite comprehensive. Plan F is the Medicare Supplement policy with the most benefits.

Medigap Plan G

Medicare Plan G, also called Medigap Plan G, is an increasingly popular Supplement for several reasons.

First, Plan G covers each of the gaps in Medicare except for the annual Part B deductible. This deductible is only $226 in 2023. In fact, if you have a Plan F that has been in place for years, we can help you on premiums by looking at Plan G. We can often find a Supplement Plan G that saves quite a bit in premiums over Plan F, usually substantially more than the $226 deductible that you’ll pay out. You pocket the difference. We can shop rates

Second, it has great coverage. For hospital stays, it covers all your hospital expenses. Most importantly, it pays the hospital deductible, which is over $1,600 in 2023. It also covers the expensive daily copays that you might encounter for a hospital stay that runs longer than 60 days. It provides an additional 365 days in the hospital after your Medicare benefits run out, and it covers your skilled nursing facility co-insurance, too.

Medigap Plan K Medicare Plan K is the Medicare Supplement that covers the Part A hospital deductible while also covering about 50% of the other gaps in Medicare.

Medigap Plan L

Medicare Supplement Plan L is another cost-sharing Medigap policy. In exchange for slightly lower premiums than what you might pay for a Plan F, if you enroll in a Medigap Plan L, the insurance carrier will pay 75% of your covered medical expenses on most items, and you will pay the other 25%. You also agree to pay the Medicare Part B deductible and any excess charges on your own.

Medigap Plan M

Medicare Supplement Plan M is one of the new Supplements created by the Medicare Modernization Act. It first hit the Medicare insurance market in the summer of 2010. (Sometimes we hear people call it Medicare Part M or Medigap Part M, but the correct term is Plan M.)

Medigap Plan N Medicare Plan N is a supplemental policy that typically has lower premiums while you pay your Part B deductible, excess charges and some copays for doctor and emergency visits. It has been popular since it was first introduced in 2010. Also called Medigap Plan N, this option was created for consumers who like the idea of paying a lower premium in exchange for taking on a small annual deductible and some copayments.

All Medicare Supplement Plan N policies are the same, no matter which insurance company you choose. You can find Plan N available in many states from various well-known insurance companies.

In a recent survey, AHIP reported that Plan N enrollment grew by 20% between 2014 – 2017. Since Plan F went away, Plan N has quickly become the runner-up for the most popular Medigap plan (after Plan G.)

(You will find that sometimes people refer to Plan N as Part N, but the proper term is Plan N. Medicare itself has parts, but when you are referring to supplemental insurance, use the word Plans.) Here is a visual picture that demonstrates what Medicare Supplement Plan N covers, and what is left for you to cover:

High Deductible G

As you may know, Medicare Plan F made a semi-exit in 2020, as did Plan C and High-Deductible Plan F. Many people who have considered getting a high deductible Medicare Supplement are left wondering what their options are now that Plan F and its accompanying high deductible Plan F plan are no longer viable options.

For beneficiaries who became eligible for Medicare on or after January 1, 2020, a High Deductible Plan G option will be available. This plan will be like the High Deductible Plan F; however, it will not cover your Part B deductible.

As with any new plan, there are looming questions of how a High Deductible Plan G will stack up against the High Deductible Plan F. Here is what you need to know about the High Deductible Plan G:

  • Original Medicare will still pay its 80% portion
  • You will pay the other 20% until you satisfy the $2,700 (in 2023) deductibles
  • After the out-of-pocket deductible is met, the plan will pay the same benefits as regular Plan G
  • The plan does not cover the Part B deductible (just like Plan G)
  • The annual Part B deductible that you will pay counts toward the total out-of-pocket deductible.