How to Choose the Best Medicare Supplement Plan

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Original Medicare can leave gaps in your coverage. These gaps can leave you on the hook for many out-of-pocket costs, but there are products that can help. Medicare Supplement plans help fill the gaps in Original Medicare coverage, and there are a number of options to choose from. In order to choose the best Medicare Supplement plan for your needs, you first need to learn about your options.

What Are My Options, and Which Is the Best Medicare Supplement Plan for Me?

A Medicare Supplement plan, also called Medigap, is sold through private insurance companies. It’s designed to help with costs left over after Original Medicare benefits are applied. That means you can only use a Medigap plan if you have Original Medicare, Parts A and B. In fact, almost one in four people on Medicare choose a Medigap plan to help with their healthcare costs.

There are 11 different Medicare Supplement plans: A. B, C, D, F, F+, G, K, L, M, and N. Each Medicare Supplement plan must include the same standardized benefits (meaning all Medigap Plan Ns offer the same coverage) regardless of carrier and location*. However, different types of Medicare Supplement plans offer different levels of coverage (meaning Plan N offers different coverage than Plan F). Medigap policies are guaranteed renewable, which means they can’t be canceled for health reasons as long as you pay your premiums.

Each plan covers basic benefits, such as:

  • Coinsurance charges through Medicare Plan A (up to 365 days after Original Medicare benefits are spent)
  • Hospice care copayments and coinsurance through Medicare Plan A
  • Copayments and coinsurance through Medicare Plan B
  • The first three pints of blood needed due to a medical procedure

Most Medicare Supplement plans do not cover:

  • Vision
  • Dental
  • Long term care
  • Hearing aids
  • Private-duty nursing
  • Prescriptions**

In order to choose the best Medicare Supplement plan for your needs, you must be aware of any out-of-pocket costs that come with each plan. These costs can include monthly premiums and yearly deductibles. For an idea of how much these premiums may be, the national average Medigap premium for Plan F is about $143 a month. Additionally, it’s important to note that Medigap plans won’t start to cover your coinsurance until your deductible is met, unless deductibles are also covered. Some plans have annual out-of-pocket spending limits, after which you’re covered 100 percent. In short, while there is no overall best Medicare Supplement plan, there is a best choice for your priorities and budget. If you need a little help determining what the best Medicare Supplement plan for you is, ask yourself the following questions.

Do you travel a lot?

You’ll probably want to select a plan that offers foreign travel emergency coverage when you’re traveling abroad. Plans C, D, F, G, M, and N pay 80 percent of qualifying emergency care in foreign countries. Foreign travel coverage begins when you meet your $250 annual deductible. You’re covered for the first 60 days you travel for qualifying care Medicare doesn’t otherwise pay for, with a lifetime limit of $50,000.

Do you want help with Part B costs?

If meeting your Part B deductible can be a hassle, Plan C or F may be the best Medicare Supplement plan for you. Both will help pay your Part B deductible, and Plan F will also kick in on your Part B excess charge (the payment between the Medicare-approved amount and the maximum a doctor can charge). And while all Medicare Supplement plans offer some coverage for Part B coinsurance and copayments, Plan K only covers 50 percent, and Plan L covers 75 percent. Plan N covers these costs 100 percent, with the exception of a $20 office visit copay or $50 emergency room copay in certain situations.

Do you want a plan with an out-of-pocket limit, so you’re protected after you’ve spent a certain amount?

Consider Medicare Supplement Plan K or L. Plan K covers you 100 percent after you’ve spent $5,240. Plan L kicks in with 100 percent coverage after spending $2,620. However, keep in mind that these two plans offer the least amount of coverage before you reach the out-of-pocket limit.

Do you want the maximum possible coverage?

Plan F may be the best Medicare Supplement Plan for you, and you’re in good company. Of people who use Medicare, 66 percent choose Plan F. It gives the most comprehensive coverage of all the Medicare Supplement plans. People with Plan F are 100 percent covered for all Medicare Supplement benefits, except foreign emergency care. Like other Medigap plans, Plan F covers 80 percent of qualifying foreign emergency care expenses. There’s also a high-deductible option sometimes known as Plan F+. While high-deductible Plan F comes with lower premium payments, it offers no coverage until the yearly deductible is met.

Do you want to save on premiums and out-of-pocket costs?

Plan G may be your best option. Plan G offers coverage on all Medicare Supplement benefits except Part B deductible costs, and it has a moderate monthly premium.

HealthMarkets Can Help Find Your Best Medicare Supplement Plan

Contact HealthMarkets to get answers for your Medicare coverage questions. Sue from Truckee, CA, had this to say about her experience: “My HealthMarkets agent explained the pros and cons of each policy in easy-to-understand terms. I was pleased with his follow-up and the ease of getting all the paperwork done.”

When you’re shopping around for the best Medicare Supplement plan for you, we want HealthMarkets to be the first resource to which you turn. Our licensed insurance agents will help you find the Medigap plan that best suits your needs and budget. It is our mission to make insurance shopping easy so you can focus on the important things in life. Call us at (800) 488-7621, or find a local agent today.


References

* Medigap plans sold in Massachusetts, Minnesota, and Wisconsin are standardized differently than those in other states.

** Policies sold before 2006 that cover prescriptions may still honor those benefits.

http://www.medicare.gov/supplement-other-insurance/medigap/whats-medigap.html | http://kff.org/medicare/report/medigap-enrollment-premiums-and-recent-trends/ | https://kaiserfamilyfoundation.files.wordpress.com/2013/04/8412-2.pdf | https://www.medicare.gov/supplement-other-insurance/compare-medigap/compare-medigap.html | https://www.medicare.gov/supplement-other-insurance/medigap-and-travel/medigap-and-travel.html