Medicare Supplement: Medigap Coverage.

Medicare Supplement plans (otherwise referred to as Medigap plans) are offered through private insurance companies and provide help to fill in some or all of the gaps that Original Medicare (Parts A and B) do not cover. Both Part A and Part B are subject to deductibles, co-payments, coinsurance, and certain other limitations. Medigap plans are designed to help fill many of those coverage gaps, and some even provide benefits that Original Medicare does not include.

Medicare Supplement plans are secondary to Original Medicare, meaning you can add a Medicare Supplement plan to Original Medicare to help pay for costs not covered. In other words, they help to wrap around Original Medicare (Parts A and B).

Remember: you must always continue to pay your Medicare Part B premium.

Medicare Supplement plans vary in which gaps in coverage they fill, but as a general rule the more generous the coverage, the higher the premium. There are ten standard plans which are regulated by federal and state laws, however not all plans are available in all states. To keep it simple, all policies with the same letter offer the same benefits.

How Much Does Medicare Supplement Cost?

Medicare Supplement plans vary in monthly premium amount, depending on which plan you choose. As a general rule: the more generous the coverage, the higher the premium.

If you need help finding the right Supplement plan, we can help you select the plan that is right for you.

What Does Medicare Supplement Cover?

Medicare Supplement plans provide help with the following:

  • Part A deductibles
  • Part B deductibles
  • Part B co-insurance and providers’ excess charges
  • First 3 pints of blood
  • Cost of additional hospital days after you’ve used up your Part A benefits
  • Hospital and skilled nursing facility co-insurance
  • Some preventive care benefits
  • Coverage when you move or travel anywhere in the United States
  • Some plans offer coverage outside the United States

How Do I Sign Up for Medicare Supplement?

Each private company that offers Medicare Supplement plans has its own enrollment process.  When you’re ready to join, we will help you expedite that enrollment process – at no cost to you.

When Can I Sign Up for Medicare Supplement?

To sign up for a Medicare Supplement plan you:

  • must be enrolled in Medicare Part A and Part B
  • must permanently live in the state in which you are applying for coverage
  • may have to answer health questions depending on when you apply for coverage

Open Enrollment Period

Six month guaranteed window beginning with Part B effective date

OEP: Open Enrollment Period

OEP: Open Enrollment Period
You can first enroll in a Medicare Supplement plan during the Open Enrollment Period, which is a six-month window beginning with your Medicare Part B effective date. During this Open Enrollment Period, Medicare Supplement policies are guaranteed issue – which means there is no underwriting or health questions you have to answer.

Outside of the Open Enrollment Period
You can still purchase Medicare Supplement plans year-round, however you may be:

  • subject to underwriting (must answer health questions)
  • charged a higher premium
  • denied coverage (not guaranteed issue)

Which Doctors Can I See?

You can choose any doctor or provider in the United States who accepts Medicare – you are not limited to a particular state or region for your care. Some policies also offer coverage for some emergency care outside the United States.

Are Prescription Drugs Covered Under Medicare Supplement?

No, Medicare Supplement plans do not cover prescription drugs. You can add drug coverage by enrolling in a stand-alone Medicare Prescription Drug Plan (Part D).

Do I Need a Primary Care Doctor or a Referral to See a Specialist With Medicare Supplement?

No, Medicare Supplement plans do not require that you choose a primary care doctor.

In most cases, you do not need a referral to see a specialist – but the specialist must be enrolled in Medicare.

What Plans Are Available Under Medicare Supplement?

Medigap Plans

There are 10 different standard Medicare Supplement plans, however not all plans are available in all states. Each plan is designated by a letter and differ in which gaps in coverage they fill. Below we explain each plan.

Medigap Plan A
Medigap Plan A covers basic benefits, including:

  • Medicare Part A hospital coinsurance + 365 extra hospital days
  • Medicare Part A hospice care coinsurance
  • Medicare Part B coinsurance
  • first 3 pints of blood each year

Medigap Plan B
Medigap Plan B covers the basic benefits of Plan A, plus:

  • Medicare Part A deductible

Medigap Plan C
Medigap Plan C covers the basic benefits of Plan A, plus:

  • Medicare Part A deductible
  • Medicare Part A skilled nursing coinsurance
  • Medicare Part B deductible
  • Foreign travel emergency

Medigap Plan D
Medigap Plan D covers the basic benefits of Plan A, plus:

  • Medicare Part A deductible
  • Medicare Part A skilled nursing coinsurance
  • Foreign travel emergency

Medigap Plan F
Medigap Plan F covers the basic benefits of Plan A, plus:

  • Medicare Part A deductible
  • Medicare Part A skilled nursing coinsurance
  • Medicare Part B deductible
  • Medicare Part B excess charges
  • Foreign travel emergency

Medigap High-Deductible Plan F
Medigap Plan F also comes in a high-deductible version, under which you must pay for Medicare-covered costs up to the deductible amount before the plan pays anything.

Medigap Plan G
Medigap Plan G covers the basic benefits of Plan A, plus:

  • Medicare Part A deductible
  • Medicare Part A skilled nursing coinsurance
  • Medicare Part B excess charges
  • Foreign travel emergency

Medigap Plan K
Medigap Plan K covers:

  • Medicare Part A hospital coinsurance + 365 extra hospital days
  • 50% of Medicare Part A deductible*
  • 50% of Medicare Part A hospice care coinsurance*
  • 50% of Medicare Part A skilled nursing coinsurance*
  • 50% of Medicare Part B coinsurance*
  • 50% of first 3 pints of blood each year*

* plan pays 100% after you reach the yearly out-of-pocket limit

Medigap Plan L
Medigap Plan L covers:

  • Medicare Part A hospital coinsurance + 365 extra hospital days
  • 75% of Medicare Part A deductible*
  • 75% of Medicare Part A hospice care coinsurance*
  • 75% of Medicare Part A skilled nursing coinsurance*
  • 75% of Medicare Part B coinsurance*
  • 75% of first 3 pints of blood each year*

* plan pays 100% after you reach the yearly out-of-pocket limit

Medigap Plan M
Medigap Plan M covers:

  • Medicare Part A hospital coinsurance + 365 extra hospital days
  • 50% of Medicare Part A deductible
  • Medicare Part A hospice care coinsurance
  • Medicare Part A skilled nursing coinsurance
  • Medicare Part B coinsurance
  • first 3 pints of blood each year
  • Foreign travel emergency

Medigap Plan N
Medigap Plan N covers:

  • Medicare Part A hospital coinsurance + 365 extra hospital days
  • Medicare Part A deductible
  • Medicare Part A hospice care coinsurance
  • Medicare Part A skilled nursing coinsurance
  • Medicare Part B coinsurance*
  • first 3 pints of blood each year
  • Foreign travel emergency

* exceptions: $20 co-payment for doctor visits and $50 co-payment for ER visits

Medigap Select Plans
Medigap Select is a type of Medigap plan sold in some states. A Medigap Select policy has a network of hospitals and doctors that a member must use (except in an emergency).

If you use out-of-network providers, the Medigap Select plan will not cover services.