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What are Medicare Supplement Plans?

Medicare Supplement plans (also known as Medigap) are supplemental insurance— not a substitute for — your Original Medicare coverage. They are designed to help pay what Medicare Part A (hospital insurance) and Part B (medical insurance) don’t pay, such as deductibles, copayments, and coinsurance. Medicare Supplement plans are offered by private health insurance companies.

Could Medicare supplement insurance be good for you?

There are several features of Medicare Supplement plans many people with Medicare may find attractive.

First, Medicare Supplement insurance fills some of the gap in your Medicare coverage and reduces your out-of-pocket expenses. All Medicare Supplement plans provide the same basic benefits, whereas some Medicare Supplement plans provide additional benefits, such as an out-of-pocket limit. Once you reach your out-of-pocket limit, you don’t pay anything more that year for your covered medical expenses. Without a Medicare Supplement plan, there may be no limit on what you can pay.

Second, Medicare Supplement plans are easy to compare. Insurance companies that offer Medicare Supplement plans must offer one or more standardized benefit packages. In 47 states, up to 10 standardized Medicare Supplement plans, labeled Plan A through Plan N, are available to people with Medicare Part A and Part B. In Wisconsin, Minnesota, and Massachusetts, Medicare Supplement plans are also standardized, but in a different way.

Third, in most cases Medicare Supplement plans allow you the flexibility to choose your own doctors and hospitals. Unless you purchase a SELECT plan, which has a network of contracted hospitals and doctors, Medicare Supplement plans generally don’t require you to use certain doctors and hospitals to receive benefits for covered services.

Fourth, you can keep your Medicare Supplement insurance if you move to another state. If you travel outside your home state and you need health care services, a Medicare Supplement plan usually will pay its portion of health care you receive. Some Medicare Supplement plans may even pay for medical emergencies in foreign countries.

Finally, Medicare Supplement plans are guaranteed renewable. Even if you have health problems, your plan generally can’t be canceled as long as you continue paying the premium.

How do Medicare Supplement plans work?

You must have Medicare Part A and Part B to purchase a Medicare Supplement insurance plan. Medicare Supplement plans are designed to work specifically with Medicare Part A and Part B. You cannot be sold a Medicare Supplement plan if you are enrolled in a Medicare Advantage plan.

Each Medicare Supplement plan covers one person—meaning your plan only covers only you and not your spouse. You and your spouse will have to buy separate Medicare Supplement plans.

You pay a monthly premium for your Medicare Supplement plan in addition to the monthly premium you pay for Medicare Part B coverage. Premiums are different depending upon the Medicare Supplement plan you choose and the insurance company you buy it from. Generally the greater the coverage, the greater the cost. However, even Medicare Supplement plans that offer exactly the same coverage often have different premiums. Insurance companies establish their own premiums. Therefore, it’s wise to compare premium prices among insurance companies once you have decided which Medicare Supplement plan type you want.

When you receive medical care, present your Medicare card and your Medicare Supplement plan card. Medicare will pay its share of the Medicare-approved amount for covered health care services. Then your Medicare Supplement plan will pay its share.

When is the best time to purchase a Medicare Supplement plan?

For most people the best time to purchase Medicare Supplement insurance is within the first six months after they are both 65 and older and enrolled in Medicare Part B. This six-month period is referred to as the Medicare Supplement Open Enrollment period. During this period, you cannot be denied Medicare Supplement insurance coverage or charged a higher premium if you have health problems.

If you decide to purchase a Medicare Supplement plan outside your Open Enrollment Period, you may have to answer health questions when you apply. The insurance company can review your health condition and use this information to make decisions about whether to charge you a higher premium. It can also restrict coverage for care related to your health condition, or deny your application altogether.

Do you want to find a Medicare Supplement plan in your area? Just enter your zip code on this page.

Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the Federal Medicare program.

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