American Benefit Services: Budgeting for healthcare coverage isn’t easy, but once you pick a plan and understand the monthly payments, you should be good, right? But have you thought about the costs that aren’t covered, the ones hiding in the “gap”? These out-of-pocket expenses can be substantial and unexpected. 

Medicare Supplements, also known as Medigap policies, are insurance plans designed to cover the “gaps” in Original Medicare, also known as Part A and Part B (you can find more info on these plans in our “Are you ready for Medicare?” post). It might seem excessive to have an insurance plan to cover the gaps of your insurance plan, but there are considerable benefits,  especially if you are on a fixed income. You may be surprised to learn that Medicare only covers  80% of your Part B expenses, leaving you responsible for the remaining 20% if you don’t have a  Medigap plan. This gap can be financially devastating if a serious illness arises. 

With ten different Medigap plans to choose from, you can find one that works for your needs and budget. These plans are there to help cover your out-of-pocket costs like copayments,  coinsurance, and deductibles while helping you budget your healthcare costs more effectively.  These plans are also accepted nationwide with any provider that accepts Medicare. Additionally,  your plan is guaranteed renewable! As long as you pay your premiums, the insurance company cannot drop you or change your coverage based on a health condition. 

Each of the ten plans offers a different combination of benefits, so finding one that works for you should be easy! Some states offer additional standardized plans, so be sure to look into those state-specific options to make sure you’re choosing the right plan for you. 

• Plan A: Basic benefits, including hospital coinsurance and hospice care.

• Plan B: Includes Plan A benefits plus the Part A deductible. 

• Plan C: Covers Plan B benefits, skilled nursing facility care, and the Part B deductible.

• Plan D: Excludes the Part B deductible but covers other Plan C benefits.

• Plan F: Most comprehensive; covers all out-of-pocket costs (not available to new enrollees as of 2020). 

• Plan G: Similar to Plan F, but does not cover the Part B deductible. 

• Plan K: Lower premiums, higher out-of-pocket costs, covers 50% of certain benefits.

• Plan L: Covers 75% of certain benefits with higher out-of-pocket costs.

• Plan M: Covers half of the Part A deductible and skilled nursing facility care.

• Plan N: Lower premiums, with copayments for doctor visits and emergency room visits. 

The best time to enroll in a Supplemental Plan is during your one-time open enrollment period,  which begins on the first day of your birth month when you are turning 65. During this period,  the Medicare Supplement company can’t ask you any medical questions. You can’t be turned down for any health conditions, and they can’t refuse a policy or charge any additional amount due to health conditions or a pre-existing illness. After this window closes, future companies may accept or decline you based on your health. 

American Benefit Services Conclusion

For the best approach to finding the coverage you need and which plan will fit your budget, be  sure to talk to your insurance agent. They can help navigate through the standardized plans listed 

above and provide you with information on any state-specific plans that could be more beneficial  to you!