Medicare Supplement Plans

Medigap Plan A, or Medicare Supplement Plan A, is a basic Medigap plan that covers the 20% of outpatient medical care Medicare expects you to take care of. 

It also provides Medicare Part B coinsurance or copayment coverage and the first three pints of blood you are normally on the hook for.

Plan A is the most basic of the 10 Medicare Supplement Insurance plans. However, it covers the most common things Medicare beneficiaries require. 

Medigap Plan A covers 100% of the costs associated with these four things: 

• Medicare Part A coinsurance payments for inpatient hospital care for up to an additional 365 days after Medicare benefits are exhausted
• Medicare Part B copayment or coinsurance expenses
• The first three pints of blood used in a medical procedure
• Part A hospice care coinsurance expense or copayment

Medicare Supplement Plan A policyholders still are on their own to pay Medicare Part A and Part B deductibles. They are also still responsible for their own skilled nursing facility care coinsurance, Part B excess charges, and foreign travel emergency costs. 

However, Plan A might be the plan of choice for people who don’t want to pay higher premiums for benefits they might not use. 

Medigap Plan A is the Medicare supplement plan available to people under 65 in some states as long as you qualify for Medicare early because of a disability. It is made available for purchase during your open enrollment period without any underwriting. 

However, the cost for this plan for people under 65 can be much higher than what a 65-year-old will pay. This is because people who qualify for Medicare due to a disability oftentimes have higher medical costs. 

Because of this, it may make more sense for those who are eligible for Medicare because of a disability may be better served by a Medicare Advantage plan. Medicare Advantage plans offer the same rate for anyone regardless of age, gender, or even disability.

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Medigap Plan B offers similar benefits as Plan A but it also includes coverage of Original Medicare’s Part A hospital deductible. 

Because Part A’s hospital deductible isn’t an annual deductible, you would be responsible for paying it multiple times throughout the year without a Medigap plan.

As previously stated, Medigap Plan B covers everything Medigap Plan A does plus your hospital deductible. This means it covers 100% of the costs associated with these four things: 

• Medicare Part A coinsurance payments for inpatient hospital care for up to an additional 365 days after Medicare benefits are exhausted
• Medicare Part B copayment or coinsurance expenses
• The first three pints of blood used in a medical procedure
• Part A hospice care coinsurance expense or copayment
• Part A hospital deductible

That last point is an important addition as it could save you several extra thousand dollars if you have more than one hospital stay in a year. Ask a licensed Medicare agent at Bobby Brock Insurance how much you could save with a Medigap policy.

You can enroll in any Medigap plan as soon as your Original Medicare Part B plan is in effect. Once you meet that requirement, you have six months to enroll in a Medicare Supplement Insurance plan with guaranteed issue. 

However, you can enroll anytime. Outside of open enrollment, you only have to answer some simple health questions.

Each insurance company that offers a Medigap plan will set their own premium based on the data in their area. This means your zip code, gender, age, tobacco usage, and other factors could affect the premium of your plan. 

Because each carrier has to offer standardized coverage with each Medicare Supplement Insurance plan, you should choose a carrier that has low rates and a healthy rating. One of our licensed Medicare agents can easily supply you with that information. Just ask!

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Medigap Plan C is a policy that covers almost all of Original Medicare’s copayment and coinsurance requirements. The one exception is Medicare Part B’s excess charges — if that is not disallowed in your state. 

Medigap Plan C covers nearly all of your copayment and coinsurance requirements. This means it covers 100% of the costs associated with these four things: 

• Medicare Part A coinsurance payments for inpatient hospital care for up to an additional 365 days after Medicare benefits are exhausted
• Medicare Part B copayment or coinsurance expenses
• The first three pints of blood used in a medical procedure
• Part A hospice care coinsurance expense or copayment
• Medicare Part A deductible
• Medicare Part B deductible
• Skilled Nursing Facility Coinsurance
• Foreign Travel Emergency

Purchasing a Medicare Supplement policy is easy. Before you apply, you only need to enroll in Original Medicare. Once your Medicare Plan B plan is active, you have a six-month window in which you can purchase a Medigap policy. During this open enrollment window, insurance companies can’t raise your premiums due to your health. 

This is why we always recommend clients enroll in a Medigap policy when they are first eligible. 

However, you can enroll at any time, so feel free to ask one of our licensed Medicare agents any questions you have about Medigap or any other Medicare policy!

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Medigap Plan D is one of the 10 standardized Medicare Supplement insurance policies meant to cover the “gaps” in coverage by Original Medicare. 

First, do not confuse Medigap Plan D with Medicare Part D. Medicare Supplement Plan D does NOT cover prescription drugs. No Medigap plan covers prescription drugs. 

However, Medigap Plan D does provide coverage for: 

• Part A hospital coinsurance and hospital costs for an extra 365 days after Original Medicare benefits are used up
• Part A hospice care coinsurance payment and copayments
• Part B copayment and coinsurance payment
• First three pints of blood for a medical procedure
• Skilled nursing facility care coinsurance
• Part A deductible
• 80% of foreign travel emergency costs up to plan limits

Plan D does not cover Medicare Part B’s deductible or excess charges. An excess charge is when a doctor charges you more the amount Medicare pays for a service. Medicare approves up to 15% excess charges. Some states do not allow for this, so ask a licensed agent with The Medicare Solutions Team if this coverage is necessary and we will gladly look into it. If your state does allow for excess charges, there are Medicare Supplement plans that do cover them.

Medigap Plan D is about in the middle between cost of premium and coverage provided when it comes to the 10 Medicare Supplement plans. 

Plan D has more coverage than Plans A and B, but there are others like F and G that have greater benefits but cost a little more.

It’s just up to you whether you want the premium savings but more out-of-pocket expenses or vice versa. 

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Medigap Plan F is the Medicare Supplement that provides the most coverage. It covers both Original Medicare Part A and B deductibles, all copays, and all coinsurance. This means you have no out-of-pocket expenses. 

Medigap Plan F features the most comprehensive benefits package out of all Medicare Supplement policies. 

Plan F covers: 

• Original Medicare Part A’s deductible
• Part B deductible
• Part B excess charges
• Part A coinsurance and hospital costs up to an additional 365 days after Medicare’s benefits are all used up
• Part B coinsurance or copayments
• First three pints of blood used in an approved medical procedure
• Skilled nursing facility coinsurance
• 80% of a foreign travel emergency (up to plan limits)

As you can see, there’s a reason Medicare Supplemental Plan F is the most frequently purchased Medigap plan according to several reports. It pays for all gaps in coverage by 

Original Medicare including your hospital and outpatient deductibles. 

That’s right, that means there are no out-of-pocket casts when you visit the doctor. 

If you’re wondering how much it is to have this peace-of-mind, give one of our licensed Medicare agents at The Medicare Solutions Team a call today!

If you take a look above at what Medigap Plan F covers, it could save you a lot of money if you visit a doctor frequently or have multiple (or lengthy) stays in a hospital.

Other than the fact you are left with no out-of-pocket expenses, there are these other benefits: 

• Choose your own doctor
• No referrals required to see specialists
• Guaranteed renewable — your coverage can’t be canceled due to health or number of claims

Medicare Part A’s deductible is currently $1,384 when you go to the hospital. You also pay 20% of any procedures. 

With Medicare Supplement Insurance Plan F, all of that is paid for by your supplement. 

So, it wouldn’t be out of the question for a Medigap plan to pay for itself in one hospital visit. 

And if you buy a plan through an independent broker like Bobby Brock Insurance, you will receive a competitive rate that most major carriers can’t reach.

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Medigap Plan G offers the second-best coverage in the Medicare Supplement realm making it the second-most popular plan among Medicare beneficiaries. 

It covers all the gaps in Original Medicare other than Part B’s deductible.

Medicare Supplement Plan G covers almost every out-of-pocket expense left behind by 

Original Medicare, including: 

• Medicare Part A coinsurance and hospital costs
• Medicare Part B coinsurance or copayment
• First three pints of blood used in an approved medical procedure
• Part A hospice care coinsurance or copayment
• Skilled nursing facility coinsurance
• Medicare Part A deductible
• Medicare Part B excess charges
• Foreign travel emergency 

The only thing it does not cover is Medicare Part B’s deductible. 

Because that lowers the premium, some Medicare beneficiaries are willing to take that risk.

A lot of people mistakenly think Medicare Supplement Plan G has a deductible. Actually, the deductible you are paying is Medicare Part B’s outpatient care deductible, which is $185 in 2019. After that deductible, Medigap Plan G covers all remaining expenses. 

If you can find a Plan G plan quite a bit cheaper than Plan F in your area, it might make more sense financially to choose Plan G due to savings. 

This is because Plan B’s deductible is only paid once annually. So, if your premium for Plan G is more than $15 cheaper than Plan F, you will be saving money. 

A licensed Medicare agent at The Medicare Solutions Team would be happy to shop Medicare supplement plans for you.

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Medicare Supplement Plan K is the Medigap plan that covers Original Medicare’s hospital deductible and 50% of coinsurance and copayment expenses. 

Medigap Plan K includes a yearly out-of-pocket limit of $5,560. This is huge because Original Medicare does not feature this benefit. So, if you were to reach your out-of-pocket limit, Medigap Plan K may cover 100% of your Medicare-covered costs for the rest of the year. 

Medicare Supplement Plan K also covers 50% of these expenses left over from Original Medicare: 

• Medicare Part A deductible
• Medicare Part A hospice care coinsurance or copay
• Skilled nursing facility care coinsurance
• Medicare Part B copayment or coinsurance
• First three pints of blood for a covered medical procedure

It does not cover Part B’s deductible, excess charges, or a foreign travel emergency.

Lots of Medicare beneficiaries elect to purchase Plan K because of its lower premiums. If you do not make lots of trips to the doctor’s office or hospital, it may be worth sharing some of the medical costs to save on monthly premiums. 

A licensed Medicare agent with The Medicare Solutions Team can evaluate your situation for free and offer you a plan suited for your budget and medical needs.

The maximum out-of-pocket limit for Medigap Plan K is $6,220 in 2021. This is the most you will have to pay out of your own pocket for Medicare-related expenses in a single year. 

If you were to ever hit this limit, your Medicare Supplement has to cover 100% of your Medicare-related expenses for the rest of the year. Because of this maximum, lots of Medicare beneficiaries will take the lower premiums offered by Plan K, knowing if they were to ever have a major health issue, the out-of-pocket limit offers a ceiling for their expenses.

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Medigap Plan L not only covers a percentage of your out-of-pocket expenses left over by Original Medicare, but it also features an annual out-of-pocket maximum limit of $2,780 (in 2019). 

Plan L is only one of two Medicare Supplement insurance policies that feature this out-of-pocket limit. Because of this popular feature and lower premiums, it may be worth the extra cost-sharing for Medicare beneficiaries.

Along with the out-of-pocket maximum ($2,780 in 2019), Medicare Supplement Plan L also features 75% coverage of these benefits: 

• Medicare Part B coinsurance or copayment 
• Part A hospice care coinsurance or copayment
• Medicare Part A deductible
• First three pints of blood used in a medical procedure
• Skilled nursing facility care coinsurance

It also covers 100% of Medicare Part A coinsurance and hospital costs up to one year after Original Medicare benefits are used up. 

Because of the portion of cost-sharing, Medigap Plan L policies have lower premiums than other supplement plans, like Plan F, that cover all leftover costs by Original Medicare.

Under Plan L, you’ll pay some out-of-pocket costs associated with Medicare. These costs could be: 

• Medicare Part B deductible
• Medicare Part B excess charges
• Foreign travel emergency

You’ll also pay 25% of your Original Medicare coinsurance or copayment costs, any skilled nursing facility coinsurance, Part A’s deductible, and the first three pints of blood for a medical procedure.

Because of this cost-sharing, you’ll pay lower premiums.

Even though you do have some out-of-pocket expenses with Medicare Supplement Plan L, there is a maximum cap. Medicare sets this limit annually. In 2019, this limit is $3,110. After you hit this limit, the Medicare Supplement insurance plan has to pay 100% of your Medicare-related costs for the remainder of the year. 

So, if covering some of your out-of-pocket Medicare expenses while still enjoying a lower premium sounds great to you, a licensed Medicare agent at The Medicare Solutions Team will be happy to help you.

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Medigap Plan M features similar benefits to other supplements, however it offers a lower premium in return for you paying part of your Original Medicare deductibles. 

Medicare Supplement Plan M covers: 

• Medicare Part A hospital and coinsurance costs for up to a year after Original Medicare benefits are used up
• Part A hospice care coinsurance and copayments
• Medicare Part B coinsurance and copayments
• First three pints of blood for a medical procedure
• Skilled nursing facility care coinsurance
• 50% of Medicare Part A’s deductible
• 80% of approved costs for foreign travel emergency (up to plan limits)

Medigap Plan M does not cover Medicare Plan B’s deductible or excess charges. This helps keep your supplement plan’s monthly premium low.

By sharing 50% of the cost of Medicare Part A’s deductible and paying Part B’s deductible ($185 in 2019), you will notice that Medigap Plan M’s premium is lower than some of the more comprehensive supplements. A licensed Medicare agent at The Medicare Solutions Team can help you decide what Medicare supplement would be better suited for your budget and healthcare needs. 

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Medigap Plan N is a supplemental policy that saves you on your monthly premium by having you pay for your Medicare Part B deductible, excess charges, and some of your copays for doctor’s office, and emergency room visits. 

Medicare Supplement Insurance Plan N covers: 

• Medicare Part A hospital coinsurance and other costs up to an additional 365 days after Original Medicare benefits are used up
• Medicare Part A hospice care coinsurance or copayments
• Medicare Part A deductible
• Medicare Part B coinsurance or copayments*
• First three pints of blood used in a medical procedure
• Skilled nursing facility care coinsurance
• 80% of foreign travel emergency care (up to plan limits)

The only thing you pay for regarding your Medicare Part B coinsurance or copayments is you’ll pay $20 copay for some doctor’s office visits and up to a $50 copay for emergency room visits if you aren’t admitted as an inpatient.

Plan N does not cover Medicare part B’s deductible or any Part B excess charges. Also, as mentioned, you may have to pay $20 copay for doctor visits and $50 for emergency room visits if you aren’t admitted as an inpatient. This allows for full coverage of a lot of other costs you’d normally be on the hook for while also keeping your monthly premium lower than comprehensive Medicare supplement plans. 

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