A Guide to What Is a Medicare Supplement Policy and Its Benefits

A Medicare Supplement policy, also known as Medigap, is designed to help fill the gaps in Original Medicare coverage.

Medicare Supplement policies can be quite confusing, but they're designed to be a straightforward way to pay for out-of-pocket costs not covered by Original Medicare.

There are 10 standardized Medicare Supplement plans, labeled A through N, each with its own unique set of benefits and costs.

To buy a Medicare Supplement policy, you must be 65 or older and enrolled in both Part A and Part B of Medicare. You also can't be enrolled in a Medicare Advantage plan.

You have a 6-month window to buy a Medigap policy, known as your Medigap Open Enrollment Period. This starts the first day of the month after you turn 65 and are enrolled in Part B.

During this time, private insurers can't deny you a policy or charge you more based on your medical history. You have more choices and can select from a range of Medigap plans.

If you're younger than 65 and qualify for Medicare due to a disability, you may be eligible for a Medigap policy in some states. However, federally guaranteed issue rights don't extend to those under 65 who qualify due to disability.

You must be 65 or older to buy Medigap insurance, and you must also be enrolled in Part A and Part B and not in a Medicare Advantage plan. Some states extend guaranteed issue rights beyond 65, and companies may choose to sell Medigap policies to Medicare recipients under 65.

During your 6-month Medigap Open Enrollment Period, you have more choices, and private insurers can't use medical underwriting to deny you a policy or charge you more for your Medigap plan. This period begins the first day of the month after you turn 65 and are enrolled in Part B.

If you drop your Medigap policy, you might not be able to get it again, or get another Medigap policy later. Once you have a Medigap policy, it is guaranteed renewable, even if you have health problems.

Here are the key requirements for buying a Medigap policy:

Medigap's history is marked by significant changes that have shaped the program into what it is today.

In 1990, federal standards were implemented for Medigap, including standardized plans and guaranteed plan renewal.

These changes brought much-needed structure to the program, making it easier for beneficiaries to understand their options.

Medigap plans were barred from offering drug coverage to new beneficiaries in 2003.

This change was made to prevent duplication of benefits with Medicare Part D.

Required insurers to offer standardized plans, such as Plan A, in 2008.

This move helped to simplify the process of choosing a Medigap plan.

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) prohibited the sale of first-dollar coverage Medigap plans to newly eligible Medicare beneficiaries in 2015.

This change affected plans C and F, which were no longer available to new beneficiaries.

If you're considering a Medicare supplement policy, it's essential to determine if you actually need one. You probably don't need Medicare supplement insurance if you have group health insurance through an employer or former employer, including government or military retiree plans.

Having a Medicare Advantage plan also means you likely don't need a Medicare supplement policy. These plans already cover many of the gaps in Medicare coverage.

If Medicaid or the Qualified Medicare Beneficiary (QMB) Program pays your Medicare premiums and other out-of-pocket costs, you might not need a Medicare supplement policy either. The QMB Program helps pay Medicare premiums, deductibles, copayments, and coinsurance.

To determine if you need a Medicare supplement policy, ask your insurance company or agent how your existing insurance works with Medicare.

A Medicare supplement policy is designed to help fill the gaps in Original Medicare coverage. These policies are standardized, meaning they have the same benefits, no matter which insurance company sells them.

You can choose from a variety of Medicare supplement plans, labeled A through N. Each plan offers different levels of coverage, so it's essential to consider your needs and budget before selecting one.

Medicare supplement policies are usually sold by private insurance companies, and you can apply for them at any time, as long as you're enrolled in Medicare.

There are 10 standardized Medicare supplement insurance plans, each labeled with a letter of the alphabet. These plans vary in the benefits they offer and the cost-sharing components.

Plan A is the most basic plan, covering hospitalization, hospice, and medical expenses, but not the Part A deductible. Plans B, C, D, F, G, and N pay the entire Part A deductible, while Plans K, L, and M pay a percentage of it.

You can choose from plans A, B, D, G, G-High Deductible, K, L, M, and N, but not all plans are offered in every state. Even if a plan is available in your state, not all insurance companies sell policies for that plan.

Here's a summary of the benefits provided by each plan:

The most popular plans among those listed are Plans G and N, while the least popular is Plan

You should ask your doctor if they accept assignment, as this affects how much you'll pay for their services.

Accepting assignment means the doctor charges only what Medicare will pay for a service.

If your doctor doesn't accept assignment, they can charge more than Medicare's approved amount.

You're responsible for paying the higher charges, and may even have to pay upfront and then wait to be reimbursed by Medicare.

Your Medicare Summary Notice will show you any charges or overcharges, and provide instructions on how to report them to Medicare.

If you're overcharged and not reimbursed, follow the instructions on the notice to report the issue.

You can also review your Medicare claims online at MyMedicare.gov.

Medicare has a directory of doctors, hospitals, and suppliers that work with Medicare, including the Physician Compare directory, which shows which providers accepted assignment on Medicare claims.

Medigap policies have some limitations to consider.

Medigap typically doesn't cover long-term care, which can include services like adult day care and home health care.

Dental care is another area that's usually not covered by Medigap.

Hearing aids and eyeglasses are also excluded from standard Medigap coverage.

Private-duty nursing is not typically covered by Medigap policies either.

You have a one-time, six-month Medicare supplement open enrollment period that begins when you enroll in Medicare Part B at age 65 or older. This is the only time companies must sell you a policy regardless of your health history or condition.

During this period, you can buy any Medicare supplement plan offered in your state, and companies must sell you a policy even if you have health problems. You can use your open enrollment rights more than once during this six-month period, so if you change your mind about a policy you bought, you can cancel it and buy another one.

You must have both Medicare parts A and B to buy a Medicare supplement policy, and if you drop your policy, you may not be able to get it back or buy a new one.

You only get one six-month Medicare supplement open enrollment period, which begins when you enroll in Medicare Part B at age 65 or older. This is your one-time chance to buy a Medicare supplement plan without being turned down due to health history or condition.

During this period, companies must sell you a policy, regardless of your health status. This means you can buy any Medicare supplement plan offered in your state, even if you have preexisting conditions.

The open enrollment period is not the same as the annual Medicare open enrollment period, when you can change Medicare Advantage and prescription drug plans. If you wait until after your open enrollment period or your policy lapses, you might not be able to buy another policy if you have a preexisting condition.

You can use your open enrollment rights more than once during the six-month period. This means you can change your mind about a policy you bought, cancel it, and buy any other Medicare supplement policy.

Even though companies must sell you a policy during your open enrollment period, they may require a waiting period of up to six months before it starts covering your preexisting conditions. This means you might not be fully covered right away, so be sure to review the policy carefully.

Shopping for a Medicare supplement policy can be overwhelming, but understanding the key factors can make the process smoother. The best time to buy a Medicare supplement policy is during your one-time, six-month Medicare supplement open enrollment period, which begins when you enroll in Medicare Part B at age 65 or older.

This six-month period is the only time companies must sell you any plan they offer without looking at your health history. This is a golden opportunity to shop around and compare prices, which can vary depending on the type of policy you get and other factors, such as where you live.

Premiums depend on the type of policy you get and other factors, such as where you live. If you have an issue-age policy, your premiums are based on your age when you bought the policy. Companies may increase issue-age policy premiums once during your first year of coverage. After that, the company may not increase the premium for 12 months.

If you have an attained-age policy, your premium could increase within the first 12 months and will increase on your birthday. It's essential to consider other things beyond price, such as a company's complaint history. You can learn a company's complaint history by visiting the TDI website or by calling our Help Line at 800-252-3439.

Ask family and friends if they've had any experiences with the companies you're considering. This can give you valuable insights and help you make an informed decision.

Medicare Supplement Plan Options are numerous, and understanding the differences can be overwhelming. You could save up to 25% with Cigna Healthcare, including a premium discount of up to 20% plus an additional 5% if you apply online.

There are various plans to choose from, each with its own set of benefits and drawbacks. Plan F has a high-deductible option, while Plans K, L, M, and N have a different cost-sharing component. Every company must offer Plan A, and if they offer other plans, they must offer Plan C or Plan F.

If you're looking for the lowest monthly premiums, Plan D might be the way to go. It has extensive coverage, similar to Plan G, and coverage kicks in after you pay the calendar year deductible. Keep in mind that you'll still have to pay the Medicare Part B annual deductible.

If you prefer to pay a lower premium versus covered out-of-pocket costs, Plan C is a good fit. You'll pay up to $20 copays for doctor's visits (up to $50 for ER visits), and you'll have to pay the Part B deductible.

Here's a breakdown of the different plans:

Remember, the best time to buy a Medicare supplement policy is during your one-time, six-month Medicare supplement open enrollment period. This is the only time companies must sell you any plan they offer without looking at your health history.