What is a Medicare supplement plan?
Medicare supplement plans, also called Medigap plans, are health insurance policies sold by private insurers to help cover the “gaps” in Medicare coverage.
While Original Medicare (Parts A and B) covers many healthcare expenses, you’re still responsible for costs like deductibles, copayments, and coinsurance. A Medigap policy steps in to cover these out-of-pocket expenses, acting as secondary insurance.
Here’s how it works:
- Medicare pays its portion of your healthcare costs first.
- Then, depending on your Medigap plan, it covers some or all of your remaining costs.
Key Features:
- Private Insurers: Medigap plans are offered by private insurance companies, not the federal government.
- Standardized Plans: The benefits of each Medigap plan are standardized and labeled by letters (e.g., Plan F, G, N). This means Plan G offers the same benefits, no matter which insurer you choose.
The most popular Medigap plans
Medicare Supplement Plan F:
Comprehensive coverage that pays 100% of your out-of-pocket costs, including deductibles, copayments, and coinsurance.
- Who Can Enroll: Only available to those who became eligible for Medicare before January 1, 2020.
- Why Choose Plan F? No out-of-pocket expenses for covered services make it simple and worry-free.
Medicare Supplement Plan G:
Offers similar coverage to Plan F, but you pay the Part B deductible ($257 in 2025).
- Why Choose Plan G? Often more cost-effective than Plan F because the lower premiums typically save you more than the Part B deductible.
Medicare Supplement Plan N:
Lower premiums but more cost-sharing. You’ll pay:
- Up to $20 for doctor visits.
- Up to $50 for emergency room visits.
- Any excess charges (up to 15% above Medicare’s rate) from certain doctors.
- Why Choose Plan N? Great for those who don’t mind minimal out-of-pocket costs in exchange for lower monthly premiums.
In total, there are 10 standardized Medigap plans (A, B, C, D, F, G, K, L, M, N).
Benefits covered by all Medigap plans
Every Medigap plan offers basic benefits, including:
- Medicare Part A coinsurance: Covers hospital costs after Medicare’s initial coverage.
- Medicare Part B coinsurance or copayment: Pays the remaining 20% of outpatient services.
- First 3 pints of blood: For necessary transfusions.
- Part A hospice care coinsurance: Covers costs for hospice-related services not fully paid by Medicare.
Some plans offer additional benefits such as skilled nursing care coinsurance, the Part A and B deductibles, Part B excess charges, and limited foreign travel emergency coverage.
What’s not covered by Medigap plans?
While Medigap plans provide excellent additional coverage, they don’t cover everything. Here’s what’s typically excluded:
- Routine dental, vision, and hearing care.
- Hearing aids.
- Eyeglasses or contact lenses.
- Long-term care.
- Prescription drugs (for this, you’ll need Part D coverage).
Medigap plans only pay after Original Medicare first covers its share. If Medicare doesn’t cover a service, your Medigap policy won’t either.
Choosing the right Medicare supplement
Helpful Tips
- Medigap plans are guaranteed renewable, so you won’t need to reapply each year.
- You can apply anytime, but outside your Medigap Open Enrollment Period, you may need to pass medical underwriting depending on your state.
- Monthly Premiums: Rates vary based on factors like age, gender, location, and tobacco use.
- Rate Trends: Review the insurer’s history of annual rate increases.
- Financial Ratings: Look at the company’s financial stability with ratings from A.M. Best or Weiss.
Key takeaways
Medigap plans fill the gaps left by Original Medicare, covering costs like deductibles, copayments, and coinsurance.
Plans F, G, and N are the most popular options, each catering to different preferences for premiums and out-of-pocket costs.
Choosing the right plan requires careful consideration of premiums, rate trends, and an insurer’s reputation.
Medigap works seamlessly with Medicare, helping you manage unexpected medical expenses with ease.
By submitting this form, you agree to be contacted by a licensed insurance agent from FTJ Senior Insurance regarding Medicare Advantage, Medicare Part D, or other Medicare-related plans. You may be contacted via phone call, email, or text message at the number and email address provided. Message and data rates may apply. Consent to contact is not a condition of enrollment or purchase. Your information will be used solely for Medicare plan-related communications. You may opt out at any time.