Introduced in 1965, Medicare was designed to provide affordable and reliable health care services to senior citizens and people with disabilities. Individuals who were eligible for Medicare faced significant financial struggles in paying for health insurance through the private sector. Medicare Part A does not include a monthly premium, which does provide some relief for seniors and people with disabilities. However, Part A has limited coverage for hospital expenses and skilled nursing facility care.
Individuals enrolled in Part A also have the option to sign up for Medicare Part B. Unlike Part A, Part B includes a monthly premium that is an out-of-pocket expense. Currently, more than 45 million Americans are enrolled in Medicare Part A and Part B.
While Medicare Part B covers some deductibles and a percentage of the cost of services after individuals pay the deductible, other medical services are not covered. Add to that the rising costs of health care over the years and you have seniors with frail health conditions who are unable to pay for needed services. The answer to these issues is Medicare Supplemental Insurance, also known as Medigap.
Medicare Supplement Plans – Benefits and Type of Plans
While Medicare Supplement plans and their benefits are not scheduled to change for coming years, there are some very important things you should know as we enter this year’s enrollment period.
- If you currently have Medicare Supplement Plan F you are likely paying too much and wasting money!
Did you know that Medigap Plan G is identical to Plan F other than who pays the annual Part B deductible? Plan G is quickly becoming one of the most popular plans available as people are saving hundreds of dollars by paying this annual deductible themselves. See below just how much YOU can save by switching to Plan G!
- You may change your Medicare Supplement Plan Anytime throughout the year!
We help shop the rates for you, so you don’t have to. Every year. Because insurance carriers have rate increase typically once per year, someone has to be watching these rates. There could be far better options to save you money for the exact same coverage simply by checking the premiums from other carriers.
Don’t be caught paying too much. Let us help!
What is Medigap?
As the name implies, Medigap is a health insurance policy to help seniors and people with disabilities pay for the gaps of Medicare coverage. The program includes a wide range of plans that are sold by private insurance companies to help with copayments and deductibles. Individuals must have Medicare Part A and Medicare Part B to apply for a Medigap policy.
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Generally, Medicare supplement plans offered by insurance companies are labeled as Medicare Supplement Insurance. Each plan is distinguished by one of the letters A-D, F-G and K-N with specific services and coverage. The benefits for each plan are identical regardless to which insurance company offers Medigap. Insurance providers, however, can decide how much to charge for coverage.
Which Medicare Supplement Plans are Best?
Typically, each supplement plan offers different benefits and premiums. Some policies have high monthly premium payments but low out-of-pocket expenses for individuals. Others require low monthly premium payments but the expenses paid out-of-pocket are high. Determining which one works best largely depends on the individual and their health condition.
Currently, only two Medigap insurance plans – Plan F and Plan G – also cover excess charges. These are charges that the patient is responsible for when a medical care provider bills more than what Medicare covers. For many patients who enroll in Plan F or G do not have out-of-pocket expenses for hospital and doctor visits. This benefit alone makes both plans more popular among people eligible for Medigap.
In addition to coverage for excess charges, Medigap Plan F has other benefits that make it appealing. This plan covers coinsurance payments under Medicare Part A, which includes an additional year of coverage after Medicare benefits are exhausted. Plan F pays Medicare Part B coinsurance and outpatient hospital services.
Other coverage for Plan F includes medical care at a skilled nursing facility. When traveling overseas, individuals are covered for medical emergencies. Individuals also have coverage for the first three blood pints per year.
Individuals may also opt for a high deductible under Medigap Plan F. If so, they are responsible for the first $2,000 of health care costs before coverage under the plan begins. This option is attractive for some individuals because of the lower monthly premiums since Plan F is one of the more costly Medicare supplemental plans.
Medigap Plan G
Similar to Plan F, Medigap Plan G also covers excess charges from healthcare providers that are not paid by Medicare. One major difference between the two plans is that individuals are required to pay the Medicare Part B deductible. This does, however, make premiums for Plan G more affordable.
Medigap Plan G provides basic coverage for individuals that include:
• Coinsurance for medical expenses under Medicare Part B
• Coinsurance for hospital stays for Medicare Part A plus an additional year after Medicare benefits expire
• Outpatient services co-payments
• Three pints of blood each year
In addition to these basic benefits, Plan G also offers:
• Hospital stay deductibles under Medicare Part A
• Emergency medical expenses based on plan limits when overseas
• Coinsurance for skilled nursing facility care
• Either partial or all at-home rehabilitation expenses that are provided by home health care services that are not Medicare approved
Medicare Supplement Plans F and G offer benefits that are not included in other plans. However, each policy comes with limitations on what is covered partially or entirely. For instance, Plan G does not cover the deductible for Medicare Part B, preventative care and hospice care co-payments. Each individual should weigh policy benefits with their health care needs.
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