Understanding Medicare Supplement Plans
Medicare supplement insurance is also known as âMedigapâ because it covers gaps in Original Medicare coverage. This supplemental insurance, offered by private companies, covers costs including deductibles, copayments and coinsurance. You pay a monthly premium for this added coverage.
There are 10 plans, each designated by a different letter, and each one covers different things.
As of Jan. 1, 2020, Medicare supplement plans are no longer allowed to cover the Medicare Part B deductible, so Plan C and Plan F are no longer available to newly eligible consumers. Anyone enrolled in either of these plans prior to Jan. 1, 2020, can keep their plans, and anyone eligible for a plan before Jan. 1, 2020 but not yet enrolled may be able to purchase one of these plans.
Disadvantages Of Medicare Part D
- Varied formularies. The prescription drugs covered under Medicare Part D vary by plan. This means that youll need to find a plan that specifically covers your medications. In some cases, you may need to make compromises.
- Coverage rules. There are some prescription restrictions under Part D coverage rules. For example, some medications require prior authorization to be filled, which can be inconvenient if you need the medicine immediately.
Best Medicare Supplement Insurance Companies
We believe this is what consumers need to know. There are many insurance companies offering Medicare Supplement . Some sell in all 50 states. A few sell regionally. And there are those who sell in only one or two states.
NO single Medicare Supplement company always has the CHEAPEST price.NO Medigap insurance company consistently is the MOST EXPENSIVE.
THE PRICE DIFFERENCE FOR VIRTUALLY IDENTICAL MEDIGAP COVERAGE CAN BE SIGNIFICANT. We post an annual Medicare Supplement Price Index that shows the lowest and highest prices for major markets.
WHY DONT WE PUBLISH THE COMPANY NAMES? Thats simple. Because insurance companies can change prices. And, frankly, we have to work with everyone. Price is important but its just one factor. Read our section on BEST QUESTIONS TO ASK.
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Compare The Difference In Cost Among Medicare Advantage Plans
If you donât want to make an account or are just looking for estimates, some companies will let you continue without logging in. However, some companies require more personal information than others before theyâll give you an estimate.
Different companies can offer different prices for two people on the same plan, depending on age and gender, so itâs worth doing some research about what your specific costs may be.
Disadvantages Of Original Medicare
- Lack of additional coverage. Original Medicare only covers hospital and medical services. This can lead to coverage gaps for services such as vision, dental, and more.
- No out-of-pocket maximum. Original Medicare has no yearly out-of-pocket maximum cost. If you have frequent medical costs, this can add up quickly.
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Anthem Blue Cross Blue Shield
Anthem offers its Medicare supplement customers access to Silver Sneakers at no additional cost in many areas. It also has a robust dental, hearing and vision plan at relatively modest prices.11
The number of available plans is limited to three or four out of 10, so if you want one of the less-popular plans, you wont be able to buy it.12
Because Anthem only operates in a few states, if you move out of its coverage area, your Medicare supplement coverage will be handled by the Blue Cross/Blue Shield company in your area, which could mean some changes that you dont like. Your costs may also be affected.13
What Are The Benefits Of Buying A Medicare Supplement Plan
The benefit of a Medicare Supplement plan is that it pays for the costs not paid for by Original Medicare. These include coverage for prescription medications, hospital stays, hospice care, bloodwork, and emergency room visits. It can drastically limit the out-of-pocket expenses that you may be hit with.
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Pros & Cons Of Medicare Advantage And Medigap Plans
There are pros and cons for both Medigap and Medicare Advantage plans based on each individuals financial situation and health circumstances.
You should compare the differences between the Medigap and Medicare Advantage plans you are considering before deciding which one you want to purchase.
Best Medigap Coverage Information: Aetna
- No. Policy Types: 7
- No. States Available: Select a state to check availability
- Providers In Network: Contact for details
Aetna offers numerous supplement plans and provides strong coverage information as well as a Medicare education section on its website so policyholders can better understand their benefits.
Information presented in multiple formats
Contact information clearly listed
Need to enter a bit of personal information to get pricing
Coverage documents are lengthy
Aetna stands out because it offers several Medicare Supplement plans, including Parts A, B, C, D, F, G, and N, with each plans information and coverage clearly laid out on the company website. Consumers are supplied with ample details to understand the options before deciding.
They also provide online information in multiple formats to better help a potential customer understand the details. However, the downloadable document with all the coverage details can be difficult to get through without guidance. Overall, we found Aetna to be very helpful and informative throughout the entire process of deciding upon a Medigap plan.
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How Do Medigap Policies Work
When you have a Medigap policy, Original Medicare will first cover its portion of the costs. Medigap will cover the remaining costs, as your plan outlines.
For example, You go to your doctors office who accepts Medicare. Your doctor bills Medicare Part B for $1,000 for your visit, and your co-insurance payment is 20% of the costs, $200. If you have a Medigap plan that pays for Part B coinsurance. Medicare will pay $800, and your Medigap plan will pay the remaining $200.
What To Know About The Best Medicare Advantage Plans
It can be hard to determine which Medicare Advantage plan is right for you. Though there are standard quality ratings, the best plan for you will depend on your specific needs.
To sift through the options, you might ask questions like: Are your drugs covered and at what cost? Do you need access to extra services to manage a specific condition? Would you rather pay more each month for lower costs later or take your chances on a higher-deductible, lower-premium plan?
These are the kinds of questions only you can answer for yourself and that will determine which plans may be better for you than others.
MoneyGeek analyzed national statistics to help you figure out the standard features of the best overall Medicare Advantage plans.
Most Medicare Advantage plans are PPO and HMO.
Most Medicare Advantage plans are either PPO or HMO, representing 46% and 39% of available plans.
There are other types of plans available.
Private fee-for-service plans pay providers for each service they provide rather than for each person they take care of. These plans dont always have a set network of providers to choose from, which means members can see virtually any provider that participates with Medicare. Only 2% of Medicare Advantage plans are PFFS.
Most Medicare Advantage plans include prescription drug coverage.
Vision, dental and hearing benefits are widespread.
Just over half of Medicare Advantage plans have $0 premiums.
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Plan F: Best Medicare Supplement Plan For Coverage
As you can see by the chart above, there is one Medicare Supplement plan that stands above the rest when it comes to the benefits offered.
Plan F is the only Medigap plan to offer coverage in each of the nine benefit areas offered by this type of insurance. Members of Plan F enjoy little to no out-of-pocket expenses because their Medigap plan picks up nearly all health care costs not paid for by Original Medicare . Roughly half of all Medigap beneficiaries are enrolled in Plan F.
However, Plan F does come with one downside. Federal legislation has made Plan F off-limits to anyone who first became eligible for Medicare on or after January 1, 2020. Only those who became eligible for Medicare before that date may enroll in Plan F. Because of that rule, we can expect to see Plan F enrollment decrease every year until it eventually no longer exists.
Medigap Plan C is the only other type of Medigap plan that is subject to the same enrollment rule as Plan F. If you were eligible for Medicare before 2020, you may still be able to enroll in Plan F or Plan C if either plan is available where you live.
Best User Experience: Humana
Humanaâs website is clear, clean, and simple. Itâs easy to navigate and get clear pricing estimates without entering personal information other than your zip code.
Ability to get estimates without having to enter personal information
Relatively limited educational information available on website
Unable to make payments via app
Several different types of plans can be overwhelming
Humana has an A- ranking from AM Best, indicating its strong financial state. We chose Humana for the Best User Experience because when you compare plans, Humana allows you to choose what kind of plans you want to seeâwhether itâs medical coverage only, prescription drugs only, or a plan that includes both.
Once youâve decided that, you can select the type of plan: HMOs, which often are offered without a premium but apply only for in-network providers PPOs or Private Fee-for-Service plans that offer in- and out-of-network coverage but with higher costs or the option to see all plans you qualify for.
The process is streamlined and straightforward, giving you the choice to enter your doctorâs name or prescription medication information to get an accurate estimate, all without having to register for an account, wait for an email, or input a lot of personal information.
Humana provides recommended plans based on your situation, including listing coverage, premiums, specialists, and prescription costs.
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Medicare Vs Medicaid Services
Medicare and Medicaid are two government programs that provide essential health care services to millions of Americans. While both are intended to help those who cannot afford to pay for medical care, there are a number of notable differences between the two programs.
For one thing, Medicare is primarily a coverage and benefits program. It is designed to help eligible individuals and families pay for medical expenses such as doctors visits, durable medical equipment, prescription drugs, hospitalization costs, etc. By contrast, Medicaid coverage focuses more on providing financial assistance with healthcare costs rather than covering specific services. This means that Medicaid recipients generally need to find their own providers or have less choice over which providers they can use.
Another distinguishing factor between the two programs is eligibility requirements. Medicare has very strict guidelines about who is eligible for coverage and benefit support, often targeting specific groups based on age or disability status. Conversely, Medicaid services eligibility rules vary greatly from state to state in some states, it may be possible for low-income families or even certain individuals with significant medical needs to qualify regardless of age or disability status.
Is A Medicare Supplement Plan Worth The Money
The average American without supplemental Medicare coverage spends about $7,473 in out-of-pocket costs while a person with Medigap spends about $6,621. The advantages of Medicare Supplement Plans is their ability to save you money and provide peace of mind about your finances if you experience an illness or accident. The disadvantage is that you may pay for coverage you do not use or need.
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Best For Preexisting Conditions: Cigna
Cigna Retirement Life Insurance Company
Cigna is known for providing coverage to clients that other companies deny.
Insurance coverage is available in 47 states and over 30 countries
24/7 Customer Service
Top rated from AM Best’s Ratings A
The website may be somewhat difficult to navigate
Cigna began in 1792 as the Insurance Company of North America and was the first-ever Marine insurer in the U.S. Today, Cigna, an A rated company by AM Best, offers Medicare Supplement plans, as well as life, accident, and health insurance.
Cigna is well-known for offering policies for people with preexisting conditions when these are not usually waived. In fact, Cigna may be the best choice for those who are applying for a Medicare Supplement plan outside of the Medigap Open Enrollment Period. Many other companies will reject applicants with serious medical conditions unless they are applying for Medicare supplemental insurance within their Medigap Open Enrollment Period. Common preexisting conditions include heart or kidney disease and diabetes, but be sure to ask whether any preexisting condition you may have will be covered.
In addition to coverage for preexisting conditions, Cigna’s website offers educational information on Medicare Supplement plans along with a helpful online platform to set up monthly payments, view policies, and request ID cards. Other features include a 7% household discount for others with a Cigna Medicare Supplement policy and gym discounts in some states.
Who Is Eligible For Medigap Plans
To be eligible for a Medigap plan, you must be enrolled in Original Medicare Parts A and B, but not a Medicare Advantage plan. You must also be in one of the following categories:
- Age 65 and older
- Under 65 and receiving disability benefits
- Under 65 and diagnosed with amyotrophic lateral sclerosis
- Under 65 and diagnosed with end-stage renal disease
Companies could delay coverage up to six months for a pre-existing condition if you didnt have creditable coverage before enrolling in Medicare.
Your Medigap open enrollment period starts the first month you sign up for Medicare Part B insurance at age 65 or older, even if you delayed enrollment because you had group health coverage. Medigap policies cannot be cancelled by the insurance company even if your health status changes as long as you pay your premiums. If youre already enrolled in a Medigap plan, you may apply to buy or switch plans.
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How Do You Decide
âMake sure you have enough coverage to limit your financial liability in case of catastrophic injuries or disease,â Nance says. âWhile the plans that have better benefits often cost more, they will usually save you in the long run in terms of out-of-pocket fees.â Nance further recommends speaking to family and friends to compare experiences.
The Best Medicare Plans: A Guide To Choosing The Right Plan For You
CEO, The Annuity Expert
Choosing the right Medicare plan can be difficult. There are so many options available, and it can be hard to know which plan is right for you. This guide will discuss the different types of Medicare plans available and help you decide which one is best for you. Well also provide information on comparing health care plans, the initial enrollment period, and finding the best deal possible. So if youre looking for information on the best Medicare plans, youve come to the right place!
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What Is A Medicare Supplement
Medicare supplemental insurance, or Medigap policy, is a type of medical insurance that helps cover some of the costs associated with Medicare, such as co-payments, coinsurance, and deductibles. Private insurers typically sell these policies and can vary widely in coverage levels and price. However, one thing that they all have in common is that they are designed to help reduce out-of-pocket medical expenses while still providing you with the peace of mind of having quality health insurance.
Whether youre looking for comprehensive coverage or need a little extra financial protection, a medicare supplement insurance policy is an excellent option for those who need reliable and affordable insurance to protect their health.
What Does Medicare Supplement Insurance Cover
Medicare Supplement insurance is sold in 12 standard plans. Plans C and F are only available to people who were eligible for Medicare before January 2020.
Every company must sell Plan A, which is the basic plan, or the “core benefit” plan. The standard plans are labeled A through L. Remember, the plans are standardized. So, Plan F from one company will be the same as Plan F from another company. Select the supplement policy which fits your needs, and then purchase that plan from the company which offers the lowest premiums and best customer service. Core Benefits: Included in all plans.
- Pays Part A Hospital copayment
- Pays for an additional 365 days of hospitalization after Medicare benefits end.
- Pays Part B copayment
You will have to pay part of the cost-sharing of some covered services until you meet the annual out-of-pocket limit. Plan K has a $6,220 out-of-pocket limit. Plan L has a $3,110 out-of-pocket limit . Once you meet the annual limit, the plan pays 100% of the Medicare copayments, coinsurance, and deductibles for the rest of the calendar year. These amounts can change each year.
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Standardized Medicare Supplement Plans
Screenshot from “Choosing a Medigap Policy,” July 8, 2019.
As you can see in the table above, Medicare Supplement insurance plans can cover the following costs:
Part A – coinsurances and hospital costs, hospice care coinsurance or copayment, and the Part A deductible
Part B – coinsurances or copayments, the Part B deductible, and any Part B excess charges
Skilled nursing facility coinsurance
The first three pints of blood for transfusions
Emergency medical costs during foreign travel
No Medicare Supplement plan covers prescription drugs. Youll have to enroll in Medicare Part D for drug coverage.
Plan A is the standard Medicare Supplement plan. All other plans build upon the benefits offered by Plan A, adding other benefits or modifying the coverage amounts.
Like all Medigap plans, Plan A covers Medicare Part A coinsurances and hospital costs 100%. That means you wont pay anything for Part A costs.
Plan A also covers 100% of coinsurances or copayments for hospice care services, 100% of Medicare Part B coinsurances or copayments for medical outpatient services, and 100% of the cost of the first three pints of blood you are administered during a procedure.
Best for: People who are looking for the lowest cost and the lowest level of coverage, especially those who dont pay the Medicare Part A deductible and can comfortably afford the Part B deductible.
Plan B covers everything Plan A covers. It also covers 100% of the Medicare Part A deductible.