Sifting through health coverage options can be a complicated task. If you're already dealing with health concerns, adding one more chore to your to-do list can feel overwhelming. However, a Medicare supplement insurance plan can save you a lot of money and provide the ideal mix of coverage to meet your health and budget needs. Sitting down to figure out the right plan is an investment that can pay off when you're no longer faced with covering the gaps.
Medicare recipients can often get sticker shock when they see the coinsurance, copayments, and deductibles that aren't covered by their current plan. Medicare supplements can fill these gaps to gain a sense of financial stability and control.
Explaining Medicare Supplement Coverage in FL
It can be frustrating to be faced with unexpected bills, and the cost of even relatively small copayments can add up when you have multiple appointments in a short period. Whether you are struggling to make these payments or want to allocate a smaller portion of your budget to these accruing expenses, supplement coverage gives you more control over how you spend your resources on medical care.
This type of coverage is often referred to commercially as Medigap. These are private plans specifically designed for people who receive Medicare benefits, and you may see them offered alongside other insurance options. If you are enrolled in Medicare Part A and Part B, purchasing private Medigap insurance plans can fill the gaps you face with these plans. Ultimately, this coverage can lower your expenses and make ongoing medical care and treatment during medical emergencies much more affordable.
Those who purchase Medigap coverage will pay a separate monthly premium to a private company. This payment is in addition to the payment made for Medicare Part B. Standardized Medicare supplement policies are guaranteed as long as the premium is paid. This means that your coverage remains in place if you have an increase in healthcare needs because of a deterioration of your health or a new medical issue.
Who Needs a Medicare Supplement Insurance Plan?
Each person must determine whether a supplemental plan is the best choice for their needs or not. For some people, medical costs are not frequent enough to warrant an additional policy at this point in time. However, if you find yourself facing frequent gaps in your Medicare coverage and having to pay out of pocket to make up the difference, you will likely benefit from these types of plans.
The need for coverage will be determined by two factors: your healthcare expenses and your budget. Those who find themselves frequently paying from their personal budget for coinsurance, copayments, and deductibles will likely benefit from Medigap coverage.
It is also important to consider the future and how medical expenses will likely increase as we age and need more ongoing care. A supplemental plan helps make sure that you have minimum personal costs for treatment even if you see an increase in your doctor's visits and treatment needs.
How to Choose the Best Medicare Supplement Policy
Once you become eligible for Medicare, you will be inundated with offers from insurance companies for Medigap (supplemental insurance) policies. Sorting through these offers can be confusing. Not only are there 12 standardized plans, but there can be huge differences in premiums between companies.
Medicare plans A and B cover only a portion of medical costs. Medigap policies are designed to fill in the "gaps" in coverage. The first step is to figure out what coverage you will need. The government currently has 8 standardized plans each represented by a letter (It used to be 10 plans, but Plans C and F are no longer availble if you became eligible for Medicare after January 1, 2020). For information about what each plan covers, read on. Medicare also publishes a guide to Choosing a Medigap Policy that explains the differences in plan coverage. The following are some other things to consider when looking at plans:
- Plans in Massachusetts, Minnesota, and Wisconsin have some extra options, so if you live in those states, check with the state department of insurance to find out the differences.
- If you regularly see doctors who charge above what Medicare pays, Plan G, which cover excess charges, may be the right plan for you.
- If you regularly travel outside the United States, Plans D, F, G, M, and N include coverage for this.
- If you have a chronic condition with high medical bills, Plan K or L may work best. Both pay only a portion of covered expenses, but have a yearly out-of-pocket cap on medical expenses. Once you reach the cap, the policy pays 100 percent of all further medical services.
Note that Medigap plans that cover the Medicare Part B deductible (Plans C and F in most states) are longer able to be sold to most people who turn 65 or who become eligible for Medicare after January 1, 2020. If you bought a Medigap Plan C or F before January 1, 2020, you can keep that plan and your benefits won’t change.
Types of Medicare Supplement Insurance Plans
There are many separate Medigap insurance plans, and they're designed to offer a range of benefits so you can choose the coverage that best fits your individual needs. Regardless of the company making the offering, Medicare Supplement plans are standardized so that you'll know exactly what's covered without any surprises (it also lets you price compare). It's best to speak directly with an experienced expert to fully apply the benefits to your unique situation.
Take a closer look at some popular plans under Medicare supplement insurance:
- Plan G: Plan G will provide the widest coverage out of the Medigap plans currently available. It provides coverage of coinsurance for Part A, 365 additional days of hospital coverage when Original Medicare coverage ends, coinsurance or copayment for Part B, skilled nursing facility coinsurance, Part A hospice coinsurance or copayment, Part A deductible, and Part B excess charges, among other coverages.
- Plan L: Like all Medigap plans, Plan L benefits include Part A coinsurance and additional hospital coverage. It also provides 75% coverage for a range of costs including Part B coinsurance or copayment, Part A hospice coinsurance or copayment, coinsurance costs for facilities using skilled nursing services, and Part A deductible. It has an out-of-pocket limit of $3,110 for 2021, which you will be expected to pay yourself.
- Plan K: Plan K has the same coverage scope as Plan L, except that the coverage rate is 50% instead of 75% and the personal expense limit is $6,220 for 2021. While the coverage is less than that of Plan L, the monthly premium will be as well.
Insurance companies may sell only Medigap or Medicare Supplement policies that fall into one of 8 standard benefit packages, ranging from basic coverage to the most comprehensive coverage. The 8 available Medigap policy packages are identified by the letters A, B, D, G, K, L, M, and N (see chart below). Plans E, H, I, and J are no longer sold, but, if you already have one, you can keep it. Starting January 1, 2020, Medigap plans sold to people new to Medicare are not allowed to cover the Part B deductible. Because of this, Plans C and F are no longer available to people who are new to Medicare on or after January 1, 2020. If you already have either of these two plans, you will be able to keep your plan. If you were eligible for Medicare before January 1, 2020 but not yet enrolled, you may be able to buy Plan C or F.
As you can see, navigating exactly which coverage will best fit your budget and healthcare needs will require some consideration of your current expenses. The plans are designed with flexibility in mind, so you are sure to find one that meets your situation.
It's also worth noting that a few Medigap insurance plans have been phased out. Both Plans C and F are no longer available to anyone who became eligible for Medicare after January 1, 2020. Those seeking new coverage will not be able to choose these options, but those who already had this coverage may keep it.
Are You Eligible to Enroll?
Medigap insurance can be purchased by those who meet the following conditions:
- Enrolled in Medicare Part A and Part B
- Have Original Medicare (not a Medicare Advantage Plan)
- Seeking coverage for a single individual (spouses will need to enroll separately)
It is also important to note that these plans provide coverage for a lot of medical expenses, but they do not cover the following:
- Dental treatment: routine dental care, fillings, etc.
- Hearing aids: fitting, devices, etc.
- Vision treatment: eye exams, eyeglasses, and contact lenses
- Private nursing care
- Prescription drugs (unless enrolled prior to January 1, 2006)
Get Started With Your Medicare Supplement Insurance Plan Today
Understanding all the options available to you for Medicare supplement insurance can be complicated. Ultimately, you want to choose a plan that fits your budget and provides the coverage you're most likely to need based on your current healthcare needs.
You can start by looking at your most recent expenses and comparing them over the course of several months. This will give you a sense of your projected ongoing healthcare costs as you see what gaps are left by your Medicare coverage. Once you have that number in mind, it will be much easier to look at the plans for supplement insurance and make a choice that makes the most financial sense.
Ideally, you will also choose a plan that provides peace of mind in case your healthcare needs increase. Having the right coverage for your situation can make sure that your budget is in tune with your treatment options, giving you the power to seek the care you need without having the excess stress of knowing how to pay for it.
Once you've decided what type of coverage you need, the next step is to decide which company to buy from. To find a list of companies that sell plans in your state, go to Medigap Policy Finder.
Each plan covers the same medical services, but premiums can vary significantly from company to company. The companies use three different methods to set premiums: attained age, issue age, or community.
- Attained-age policies set the premium based on your age, so the premium automatically increases as you get older. Before buying an attained age policy, check with the insurance company to get the premium costs for the next age increments, so you'll know the level of increases to expect each year.
- Issue-age policies set the premium at the age you first buy the policy. The premium will never be higher than the amount the company is charging new buyers at the same age. For example, suppose you buy the policy at age 65. In five years, the premium will be the amount the company is charging new 65-year-old buyers. While your premiums may increase, the increases may not be large because the company will keep premiums lower to attract new buyers.
- Community policies charge the same price to everyone in your area regardless of your age. The premiums go up only when the insurance company raises premiums on all policies of the same type. These increases are regulated by state insurance departments.
While the premiums on an attained-age policy may be lower at first, it is generally better to buy an issue-age or community policy, which may be more expensive at first but doesn't increase as much over time.
Following are some other things to keep in mind when choosing a policy:
- Look for a company that has arranged to file Medigap claims automatically. Companies that offer automatic filing of claims with Medicare can save time and effort.
- It is a good idea to purchase from a financially sound company. Make certain that the insurer is rated in the top two categories by one of the services that rates insurance companies, such as A.M. Best or Weiss.
- Contact your state insurance department to find out if the insurance company has any complaints filed against it.
When you're prepared to sign up, reach out today to discuss which one will best meet your needs. We will be happy to help you go through the options and make the best choice!
Start your free consultation
Share your experience and we will call you