How to Compare Medigap Plans

How to Compare Medigap Plans

In this post we provide an overview of how to Compare Medigap Plans, also known as Medicare Supplement Plans.

Original Medicare does not fully cover the allowable Medicare expenses. Only Medicare Supplement plans cover all Original Medicare gaps (or most of them depending on the nature of the plan): deductibles, copayments/ coinsurances, and excess charges. They are sold by private insurance companies licensed in your state. Here is the list of the major benefits of Medicare Supplement Plans:

  • There is no network for Medicare Supplement. You may visit any doctor or hospital, and as long as the doctor/hospital is accepting Medicare, they MUST accept Medigap plan as the secondary coverage.
  • All Medicare Supplement plans are guaranteed renewable, i.e. insurance company cannot cancel your policy as long as you pay the premium.
  • Medicare Supplement benefits are paid by Medigap vendors after Medicare has paid its share of the bill.
  • Medigap provides extra benefits that are not a part of Original Medicare, such as foreign travel emergency. Several companies provide additional benefits such as pharmacy savings, vision discount, access to fitness facilities, nurse health line, etc.

How to compare Medigap Plans: Standardized Medicare Supplement Plans

In order to learn how to compare Medigap plans, it is important first to review the concept of Standardized Medicare Supplement Plans. There are 10 Standardized Medigap Plans. Each plan has a designated letter (Plan A, Plan B, etc.) and a specific set of basic and extra benefits.

All Medigap plans are standardized, i.e. they have common standards in:

  • Medigap Benefits: Any plan from one insurance company has the same benefits as the same plan from another company
  • Claim Processing: All insurance companies process claims electronically. It is done through the very efficient Medicare crossover system.
  • Claims Decisions: Medicare makes claim decisions, not the Medigap insurance company

Here are three categories of Medicare Supplement plans:

The table below presents 2015 Standardized Medigap Plans, and is critical in learning how to compare Medigap plans. Notice, that a specific benefit for a particular plan is covered by certain percentage, if the cell is not empty (X stands for 100% coverage)

Medicare Supplement Plans

Medicare Supplement Benefits

A

B

C

D

F*

G

K

L

M

N

Medicare Part A Coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up

X

X

X

X

X

X

X

X

X

X

Medicare Part B Coinsurance or Copayment

X

X

X

X

X

X

50%

75%

X

X**

Blood (First 3 Pints)

X

X

X

X

X

X

50%

75%

X

X

Part A Hospice Care Coinsurance or Copayment

X

X

X

X

X

X

50%

75%

X

X

Skilled Nursing Facility Care Coinsurance

X

X

X

X

50%

75%

X

X

Medicare Part A Deductible

X

X

X

X

X

50%

75%

50%

X

Medicare Part B Deductible

X

X

Medicare Part B Excess Charges

X

X

Foreign Travel Emergency (Up to Plan Limits)

80%

80%

80%

80%

80%

80%

Out-of-Pocket Limit None None None None None None $4,940 $2,470 None None

 

* Medicare Supplement Plan F offers also a high-deductible plan.
** Medicare Supplement Plan N pays 100% of the Part B coinsurance with the exception of up to $20 copayment for some office visits and up to $50 for emergency room visits.

How to compare Medigap Plans:  Plans’ Recommendations

This Section provides some tips on how to compare Medigap plans. We simplicity, we limit ourselves only with the most popular plans.

Compare Medigap Plans – Plan A

Medicare Supplement Plan A, is often referred to as the Basic Supplemental Insurance Plan.  All insurance companies selling Medigap policies must offer Plan A.

Medicare Supplement Plan A offers only the basic coverage, therefore, its price is more affordable compared to any other plan. Enroll in this plan if you prefer to have only critical benefits, and are prepared to assume the remaining risk.  For some, this plan is the right choice.

Compare Medigap Plans – Plan F

Medicare Supplement Plan F is the most comprehensive Medicare Supplement plan available. It covers all Medicare ‘gaps’, and is the only plan that includes both Medicare Part B deductible and Medicare Part B excess charges. It is also the most popular plan. Most Medicare Supplement insurance companies offer Medigap Plan F.

Because the Medicare Supplement Plan F covers all Medigap “gaps”, you won’t have any out-of-pocket expenses when you visit a doctor or hospital. This plan, however, is the most expensive. Select Plan F if the security and predictability of not having to pay anything out-of-pocket (other than premium) is the most important for you.

In addition to Plan F, some vendors offer High-Deductible Medicare Supplement Plan F. It is the same as Medigap Plan F, except that you have to pay the deductible amount ($2,180 in 2015) before your Medigap Plan pays anything. Naturally, the premium for the high-deductible plan F is substantially lower than the premium for the standard plan F.

Compare Medigap Plans – Plan G

Medigap Plan G, also known as Medicare Supplement Plan G, covers all Medicare ‘gaps’ with the exception of Medicare Part B Deductible. The Plan G premiums vary quite extensively between companies. Only selected Medicare Supplement insurance companies offer Medigap Plan G.

Medigap Plan G is one and the same with the Medigap Plan F, excluding the fact that it does not cover Medicare Part B deductible. As long as the difference between plan F and plan G premiums exceeds the Part B deductible, it makes sense to go with Plan G. Use Medigap Plan G (if available) when savings in premium justify removing Medicare Part B Deductible from the benefits.

Compare Medigap Plans – Plan N

Medigap Plan N, also known as Medicare Supplement Plan N, is one of the two new Medigap plans introduced in June of 2010. In order to lower monthly premium costs, Plan N uses copays which include: up to $20 for a doctor’s visit, and $50 for emergency visits. The result is an affordable and very popular plan with a monthly premium 25%-35% lower than the all-covering the Medigap Plan F. Most (but not all) Medicare Supplement insurance companies offer Plan N.

Medigap Plan N is the right choice for anyone in good health who only visits a doctor occasionally and doesn’t want to be over insured.

For those who are now enrolled in Medicare Advantage and would like to return back to Original Medicare it is important to note that because Medigap plans don’t have network restrictions, and much lower out-of-pocket expenses, Medigap Plan N provides a cost-effective alternative to Medicare Advantage.

Ultimately, for people who are healthy or on a fixed income, Medicare Supplement Plan N premium savings may offset benefits presented in more expensive plans, such as Medigap Plan F. Good health is important: savings in premium payments using Medigap Plan N will not compensate you for the money spent on copayments if you see a doctor on a frequent basis (let’s say twice per month).

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Contact Us

Liberty Medicare is here to help you how to compare Medigap plans, and how to select and enroll in the best and most suitable Medicare Supplement Plan for you.

All of our services are offered to you at no cost. We’ll help you:

  • Find all available to you plans and compare their benefits
  • Determine your eligibility (particularly if medical underwriting is required)
  • Find the least expensive Medigap plan and enroll into it

Learn more about all benefits of working with Liberty Medicare.

If you are looking for Medicare Supplement coverage, please contact Liberty Medicare, or give us a call at 877-657-7477.

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