Medicare Supplement plans, also known as Medigap plans, are designed to help cover the gaps in Original Medicare costs. They are secondary plans that will help cover costs for Part A and Part B services once Medicare pays its portion first. The coverage varies with each plan, and there are ten standardized Supplement plans available in most states. However, Medicare Supplements are just one option a Medicare beneficiary can choose when they become eligible. The other option is to choose a Medicare Advantage plan which is significantly different from a Medicare Supplement plan. Many people do not know the differences between Medicare Advantage verses Medicare Supplement, but here is what you need to know about Medicare Supplements in 2022.

How Medicare Supplement Plans Work

Most states offer ten Medicare Supplement plans. Each plan is standardized, which means every insurance company that provides a specific plan must offer the same benefits as another insurance company. If Medicare pays, they all must pay for a service, but some plans offer more comprehensive coverage.

You must be enrolled in Medicare Part A and Medicare Part B to enroll in a Medicare Supplement plan. You will have to pay an additional premium for your Medigap plan, but you will pay less out-of-pocket for cost-sharing expenses during the year. The costs are predictable, and you won’t have surprises compared to Medicare Advantage plans. If you need more in depth information on the different plans, We Speak Medicare from Boomer Benefits would be a great first step in learning more.

Cost-sharing with Medicare Supplements

Since each plan covers different benefits, the cost-sharing with each plan will vary. However, all Medigap plans must cover the Part A coinsurance and hospital costs at 100%. The other benefits such as Medicare Part B coinsurance or copayments, cost of blood, Part A hospice care copayment, skilled nursing facility coinsurance, Part A deductible, Part B deductible, Part B excess charges, and foreign travel emergency coverage may or may not be covered 100% by the plan.

The top three most popular plans in 2022 are Plan F, Plan G, and Plan N. However, Plan F is no longer available to those new to Medicare as of January 1, 2020. Plan F is the most comprehensive plan as it covers all the benefits stated above. However, the premiums tend to be higher than most other plans.

Plan G can be more cost-effective even though you are responsible for paying the Part B deductible, which is $233 in 2022. The next popular Medicare Supplement plan is Plan N. The difference between Plan G and Plan N is Plan N has $20 copays for office visits and $50 copays for ER visits. Additionally, you are responsible for Part B excess charges.

Medicare Supplement Networks

Original Medicare is primary when you are enrolled in a Medicare Supplement plan. Whenever you go to a hospital or provider, you will only need to ask them if they accept Original Medicare. If the doctor accepts Original Medicare, they must accept your Medigap policy no matter the plan or insurance carrier. Since Medicare can be used anywhere in the U.S., then so can your Medicare Supplement policy. Additionally, you do not need referrals for specialists or other doctors when enrolled in Medicare Supplemental plans.

What are Services Not Covered by Medigap Plans?

Medicare Supplement plans will only cover services that Medicare covers. Since Medicare does not cover prescription drugs, gym memberships, dental, vision, and hearing, a Medigap plan will not cover them either.

What is the difference between Medicare Advantage vs Medicare Supplement?

You must be enrolled in Part A and Part B to enroll in a Medicare Supplement plan or Medicare Advantage plan. Many people are unaware of the difference between Medigap vs Medicare Advantage. Medicare Advantage plans are an alternative way to receive your Medicare benefits. Your Advantage plan manages your care, and you must stay within your plan’s service area to have coverage. Most Advantage plans include prescription drug benefits, so you would not need an additional Medicare Part D plan. However, Medicare Supplements plans work alongside Medicare and will as secondary insurance. Since Medicare does not cover drugs, you would need to enroll in a Part D plan.

Conclusion

All Medicare Supplement insurance companies can choose which plans they offer to Medicare beneficiaries. They can set their plan premium how they see fit based on your age, location, and more. To learn more about your Medigap coverage options, you can consult with a Medicare broker for more information.