In Michigan, eligible seniors can purchase Medigap policies to supplement their Medicare coverage. There are 10 standardized Medigap policies, labeled A through N, each offering different levels of coverage.
Medigap policy A is the most basic, covering only Medicare Part A coinsurance and hospital costs. It's a good option for those who are on a tight budget.
Medigap policies C and F offer more comprehensive coverage, including Medicare Part B coinsurance and copayments. These policies are popular among seniors who want more protection.
Eligible seniors can purchase Medigap policies from private insurance companies, but the state of Michigan regulates the policies to ensure they meet certain standards.
Understanding Medigap Policies
There are 10 standard Medigap plans, but not all insurance companies offer all plans. Priority Health, for example, offers Plans A, C, D, F, G, and N.
Plan A covers the least, and Plan F is one of the most popular plans, covering the most. You should compare monthly premiums, copayments, coinsurance, and deductibles when choosing a Medigap plan. Medigap plans don't include prescription coverage.
Medicare Supplement Plan G is the most popular plan available to those eligible after 2010, with an enrollment of about 4.5 million in 2021. It covers a broad range of expenses, including Part A coinsurance, Part A hospice care coinsurance, and Part B coinsurance.
What Is?
Medigap policies are a type of supplemental insurance that helps pay for out-of-pocket expenses not covered by Original Medicare.
There are 10 standard Medigap plans, but not all insurance companies offer all plans. You can choose from Plans A through N, but only some companies offer all of them.
Plan F is the most popular Medigap plan, covering everything Plan C covers, plus Part B excess charges. It's available in a high-deductible version, where you must pay $2,800 out-of-pocket before your plan starts covering expenses.
Plan G is the second most popular Medigap plan, covering a broad range of out-of-pocket costs, including Part A coinsurance, Part B coinsurance, and Part B excess charges. It's also available in a high-deductible version.
Plan C offers comprehensive coverage for Part A coinsurance, Part A hospice care, skilled nursing care, and more. It's a good option for those who want help covering their deductibles.
Plan A provides the most limited coverage, covering only coinsurance or copayment for Part A, Part B, and hospice care. It's a good option for those who can cover their deductibles out of pocket.
Plan L has a lower out-of-pocket maximum of $3,530 in 2024, but doesn't cover international emergency medical care. It's a good option for those who want a lower out-of-pocket maximum.
Plan M is the least popular Medigap plan, covering 50% of your Part A deductible and all other out-of-pocket costs. It's a good option for those with savings who can pay half of their Part A deductible.
Plan K covers a percentage of out-of-pocket expenses until you hit a maximum out-of-pocket amount of $7,060 in 2024. It's a good option for those who want a cheaper Medicare Supplement plan.
Here's a comparison of the most popular Medigap plans:
What Is B?
Medicare Supplement Plan B is a popular option for those who want help covering their medical expenses. It's the third most popular plan, with around 182,000 people enrolled in 2021.
Plan B offers more coverage than Plan A by adding the Part A deductible coverage. This means that it helps pay for the deductible associated with Part A.
Plan B covers Part A coinsurance/coinsurance, Part A hospice care coinsurance/copayment, Part A deductible, Part B coinsurance/copayment, and the first three pints of blood. This can be a huge help for those who need medical care.
Here's a breakdown of what Plan B covers:
- Part A coinsurance/coinsurance
- Part A hospice care coinsurance/copayment
- Part A deductible
- Part B coinsurance/copayment
- First three pints of blood
Plan B can be a good option for people who want help covering their medical expenses, especially the Part A deductible.
Anthem Insurance Options
Anthem offers four types of Medicare Supplement plans, each with its own benefits and premiums. You'll pay a monthly premium, which can range from $102 to $226, but it can help you control costs.
The plans are standardized, so coverage under a specific plan type remains the same no matter which company issues the policy. You'll pay a deductible for Part A and Part B, and Anthem's Plan N pays 100% of Part B coinsurance, except for certain copayments.
Here's a comparison of Anthem's Medicare Supplement plans:
Options
If you're looking for a Medicare Supplement plan, you have several options to consider. Cigna Healthcare offers a premium discount of up to 20% plus an additional 5% if you apply online, which can save you up to 25% on your premium.
You can compare all Medicare Supplement plans side-by-side to find the one that best fits your needs. Some plans, like Plan G, offer extensive coverage and competitive premiums, but you'll still need to pay the Medicare Part B annual deductible.
Plan F is another popular option, offering the same coverage as Plan G, but with lower monthly premiums. However, you'll need to pay the calendar year deductible before coverage kicks in.
If you're looking for the lowest monthly premiums, Plan K might be a good fit. You'll pay up to $20 copays for doctor's visits and $50 for ER visits, but you'll have lower out-of-pocket costs overall.
Other plans, like Plan L, offer additional coverage for costs not covered by Original Medicare, but you'll need to pay the Part A and Part B deductibles.
Ultimately, the right plan for you will depend on your individual needs and budget. It's essential to compare all your options and choose the one that provides the benefits you need at a price you can afford.
Here are some key features of each plan:
Remember, Medicare Supplement plans do not include prescription drug, dental, and vision coverage, but you can purchase stand-alone plans for these benefits separately.
Anthem Insurance Options
Anthem offers a range of Medicare Supplement plans that can help you control costs. Each plan is standardized by the federal government and named with a letter, like A, F, G, and N.
You'll pay a monthly premium, which can range from $102 to $226. The main difference between insurance companies is the price of the policy and the types of policies available.
Anthem offers four plans with varying benefits, including coverage for Part A coinsurance and hospital costs, Part B coinsurance or copay, and skilled nursing facility care coinsurance.
Here's a brief overview of Anthem's Medicare Supplement plans:
Keep in mind that Anthem's plans may vary in terms of coverage and costs, so it's essential to review the details carefully.
Enrollment and Coverage
You can enroll in a Medicare Supplement plan at any time if you already have Original Medicare Part A and Part B. The best time to enroll is during the Medigap Open Enrollment Period, which starts the first month you have Medicare Part B and you’re 65 or older.
This period is crucial because you cannot be denied coverage even if you have pre-existing health problems. If you enroll later, you may be denied coverage because of a pre-existing condition.
You can also enroll during your Initial Enrollment Period, starting three months before you turn 65, and ending three months after the month you turn 65. This period allows you to enroll in a Medigap policy, but you may not be guaranteed coverage.
To enroll in a Michigan Medigap plan, you'll need to go through a private insurance company, as plans are available to Medicare Part A and B enrollees. If you're already enrolled in a Medicare Advantage plan, you're not eligible to purchase a Medigap policy.
Here are the key enrollment periods to keep in mind:
- Medigap Open Enrollment Period: starts the first month you have Medicare Part B and you’re 65 or older
- Initial Enrollment Period: starts three months before you turn 65, and ends three months after the month you turn 65
Enrollment Process
You can enroll in a Medicare Supplement plan at any time if you already have Original Medicare Part A and Part B. The best time to enroll is during the Medigap Open Enrollment Period.
This period starts the first month you have Medicare Part B and you're 65 or older. During this time, you cannot be denied coverage even if you have pre-existing health problems.
You also can enroll during your Initial Enrollment Period, starting three months before you turn 65, and ending three months after the month you turn 65.
If you're enrolled in a Medicare Advantage plan, you aren't eligible to purchase a Medigap policy.
To enroll in a Michigan Medigap plan, you'll need to work with a private insurance company. Plans are available to Medicare Part A and B enrollees.
Here's a breakdown of your enrollment options:
- Medigap Open Enrollment Period: starts the first month you have Medicare Part B and you're 65 or older
- Initial Enrollment Period: starts three months before you turn 65 and ends three months after the month you turn 65
- Eligibility: 65 or older and enrolled in a Medicare Part B plan, or in some states, younger than 65 and qualifying for Medicare due to a disability.
During your Medigap open enrollment period, insurance companies may not use medical underwriting processes to determine eligibility or set premium rates.
Eligible Prior to 2020
If you turned 65 and became eligible for Medicare before 2020, you're eligible for two more plans: Plan C and Plan F.
Plan C doesn't cover "excess charges", which means you'll have to pay the difference if a doctor charges more than the Medicare-approved rate for a service.
Plan F, on the other hand, does cover "excess charges", so you won't have to worry about paying extra.
Both Plan C and Plan F cover the Part B deductible, which is a significant cost savings.
Choosing a Medigap Policy
There are 10 standard Medigap plans in Michigan, but not all insurance companies offer all plans. Priority Health offers Plans A, C, D, F, G, and N.
The main difference between Medigap plans is what they cover and how much they cover. For instance, Plan K and Plan L will only cover a portion of certain costs, such as coinsurance for skilled nursing care. Others, like Plan G, provide complete coverage for most out-of-pocket costs.
To find the most affordable plan for you, comparing plans from a few insurers is a good idea. The cost of Medigap insurance can vary significantly depending on the state's rating approach, the plan, whether you smoke, the insurance company, and your age.
Here are some of the most popular Medigap plans in Michigan, which may have lower premiums: Plans F, G, and N. These plans offer numerous benefits, including coverage of the Part A deductible, 100% of the coinsurance for skilled nursing facility care, and 80% of foreign travel exchange.
Eligibility Criteria
You can enroll in a Medicare Supplement policy at any time if you're 65 or older and enrolled in a Medicare Part B plan. This is a great option if you're looking for extra coverage beyond what Medicare provides.
If you're turning 65, you can enroll in a Medicare Supplement policy during your 6-month open enrollment period. This is the first day of the month after you turn 65 and are enrolled in Part B, and it's a good time to sign up because you can't be turned down for coverage during this time.
In some states, if you're younger than 65 and qualify for Medicare due to a disability, you may also be eligible for a Medicare Supplement policy. This is worth looking into if you're in one of these states.
To be eligible for a Medicare Supplement policy, you must not have any other health insurance that would cover the same expenses as the policy. This means you can't have any other insurance that pays for the same medical expenses as Medicare.
How to Choose
Choosing a Medigap policy can be a daunting task, but with some guidance, you can make an informed decision. Consider your personal coverage needs, as this will help you choose a plan that provides the best coverage for out-of-pocket expenses.
When comparing Medigap plans, think about the type and amount of plan coverage. For instance, Plan K and Plan L will only cover a portion of certain costs, such as coinsurance for skilled nursing care. Others, like Plan G, provide complete coverage for most out-of-pocket costs.
The cost of Medigap insurance can vary significantly depending on the state's rating approach, the plan, whether you smoke, the insurance company, and your age. To find the most affordable plan for you, comparing plans from a few insurers is a good idea.
You should also consider the plan cost, as this can be a significant factor in your decision. The cost of Medigap insurance can vary widely depending on these factors.
Here are some popular Medigap plans to consider:
- Plan F, which covers the Part B deductible
- Plan G, which provides complete coverage for most out-of-pocket costs
- Plan N, which covers your Part B out-of-pocket expenses with low copays for office visits and emergency room visits
These plans may be more popular due to their lower premiums and comprehensive coverage. However, they may come with higher deductibles, which means there's an additional outlay of money before reimbursement begins.
What Is D?
Medicare Supplement Plan D is a popular option among those eligible, with about 151,000 Americans having it in 2021. It's the fourth most popular plan out of eight available options.
Plan D adds emergency coverage in foreign hospitals and skilled nursing facility coinsurance to the available benefits. This is a significant advantage for those who travel abroad or require extended care at a skilled nursing facility.
The plan offers a range of benefits, including:
- Part A coinsurance/coinsurance
- Part A hospice care coinsurance/copayment
- Part A deductible
- Part B coinsurance/copayment
- First three pints of blood
- Skilled nursing facility care coinsurance
- Foreign travel coverage
It may be more challenging to find Plan D in your state, as insurers weren't as likely to offer it as many other plans.
Frequently Asked Questions
What is the downside to Medigap plans?
Medigap plans, including Plan G, have high monthly premiums and don't cover prescription drugs, making them a costly option for some. If you're considering Medigap, it's essential to weigh these downsides against the benefits to make an informed decision.
How much does Medigap cost in Michigan?
Medigap premiums in Michigan can range from $90 to over $200 per month. If you're looking for more information on Medigap costs and options, keep reading to learn more.
What is the most common Medigap policy?
The most common Medigap policy is Plan G, which accounts for 39% of all policyholders. This plan is chosen by nearly 5.3 million people, making it the most popular option in 2023.
Are Medigap policies being phased out?
Medigap policies are not being completely phased out, but some types, like Plans C and F, are no longer available to new beneficiaries. Existing policies remain in effect, but new policies have some restrictions starting in 2020.
What is the best medicare supplemental plan?
The best Medicare supplemental plan depends on your specific needs, but top options include Humana for extra benefits, State Farm for straightforward coverage, AARP by UnitedHealthcare for extensive medical care coverage, and Blue Cross Blue Shield for a range of Medigap plans. Consider your priorities to choose the best fit for you.
Sources
- https://www.cigna.com/medicare/shop-plans/supplemental/
- https://www.anthem.com/medicare/medicare-supplement-plans-medigap
- https://www.priorityhealth.com/medicare/learning-center/medicare-explained/extra-credit/best-medicare-supplement-plans
- https://www.investopedia.com/compare-medicare-supplement-plans-8606543
- https://www.helpadvisor.com/medicare/michigan-medicare-supplement-plans
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