Medicare Supplement Plans
At Pro Insurance Resources, we ensure you have the comprehensive coverage for your needs.
What is a Medicare Supplement Plan?
Medicare Supplement (also called Medigap) plans are private insurance policies designed to work together with Original Medicare Parts A and B. While Original Medicare covers a significant portion of your healthcare expenses, it doesn’t cover everything. Medigap plans help cover out-of-pocket costs Medicare doesn’t fully pay, such as deductibles, copayments, and coinsurance.
Types of Medigap Plans
Plans are standardized by letter — Plan A through Plan N — and each letter provides a different set of benefits. Regardless of the insurance company, coverage is the same for each plan letter.
Three of the most popular options include:
- Plan G: Covers everything except the Medicare Part B deductible. A top choice for new enrollees.
- Plan N: Offers lower premiums with some cost-sharing for doctor visits and ER trips.
- Plan F: Offers full coverage, including the Part B deductible. Only available if you became eligible for Medicare before January 1, 2020.
Note: Plans E, H, I, and J are no longer sold, and Plans C and F are restricted to beneficiaries who became eligible before 2020 (even if they enrolled later).
Key Features: Original Medicare plus a Medigap Plan
More Predictable Costs & Coverage
Covers major out-of-pocket expenses, helping you avoid surprise bills. Coverage for each Medigap letter plan is the same across carriers (though premiums may vary).
Freedom to Choose Providers
Medigap plans are not tied to a specific provider network. Use any doctor or specialist who accepts Medicare — no network restrictions.
Guaranteed Renewability
As long as you pay your premium, your Medigap plan will renew yearly. The insurer can’t cancel your policy or raise rates due to health conditions.
Travel Coverage
Some Medigap plans (like D, G, M, and N) include foreign emergency medical coverage, which Original Medicare does not.
Enrolling in a Medigap Plan
You can join, switch, or drop a Medicare Supplement plan during:
- Your Medigap Open Enrollment Period:
This window starts as soon as you enroll in Medicare Part B. For the next six consecutive months, you have guaranteed issue rights, which means insurance companies can’t deny you coverage or charge you more due to specific health conditions. - After this Medigap Open Enrollment period, you could face waiting periods, denied coverage, or higher premiums for pre-existing conditions, unless you qualify for a Special Enrollment Period for guaranteed issue.
- To enroll in a Medigap plan, you must already be enrolled in Original Medicare Parts A and B.
- Medicare’s Annual Enrollment Period (Oct 15 – Dec 7) does not include Medigap plans. You can apply to switch plans or carriers for a Medicare Supplement plan at any time during the year. However, as noted above, your approval is not guaranteed and will depend on medical review once guaranteed issue rights have expired.
Important enrollment notes:
Choosing a Medigap Plan
Before choosing a Medigap plan, consider:
- Benefits: Evaluate extra benefits, such as foreign travel or emergency coverage.
- Costs: Premiums vary by insurer, even for plans with the same letter. Get multiple quotes and compare costs. You can review options on Medicare.gov and ask us for guidance.
- Coverage Needs: Are you more concerned about ER visits, deductibles, or copayments? Consider which plans cover your top priorities.
Comparing Medigap and Medicare Advantage
| Feature | Medigap (Supplement)* | Medicare Advantage (Part C) |
|---|---|---|
| Works with Original Medicare | Yes | No - replaces it |
| Provider Flexibility | Any Medicare provider | Typically in-network only |
| Extra Benefits (dental, vision) | Not included | Often included |
| Prior Authorization | Usually not required | Usually required for specialist services |
| Emergency Travel Coverage | Some plans offer it | Many plans offer it |
*Must be purchased in addition to Original Medicare (Parts A and B)
Medicare Supplement Frequently Asked Questions
Can I have both Medigap and Medicare Advantage?
No. You can enroll in one or the other, but not both. Medigap is an addition to Original Medicare, while Medicare Advantage combines Parts A and B of Original Medicare, often with some added benefits.Does Medigap include prescription drug coverage?
No, you’ll need a separate Part D plan for prescription drugs.Can I switch Medigap plans later?
Yes, you can apply for a switch in plans or carriers at any time, but unless you qualify for a special enrollment period, you may be subject to a medical review. In this case, existing health conditions could result in higher premiums, waiting periods, or denial.
Medigap
What are Medicare Supplement Plans?
Medicare Supplement or Medigap plans are private insurance policies designed to complement Original Medicare (Part A and Part B). While Original Medicare covers a significant portion of your healthcare expenses, it doesn’t cover everything. Medigap plans cover the costs that Medicare doesn’t fully pay, such as deductibles, copayments, and coinsurance.
Benefits of Medicare Supplement & Medigap Plans
Purchasing a Medicare Supplement or Medigap plan can provide many benefits for seniors. These include:
Consistent Coverage: Each Medigap plan letter provides the same coverage, regardless of the insurance company. However, costs can vary from company to company.
Insurance Gap Coverage: Original Medicare provides substantial coverage for hospital and medical services but doesn’t cover everything. Medigap plans help pay for costs that Medicare does not cover. This coverage can include things like Part A (hospital) deductible, Part B coinsurance or copayment, and foreign travel emergencies.
Guaranteed Renewal: As long as you pay your premium, your Medigap or Medicare Supplement policy will renew yearly. An insurance company cannot cancel your policy or raise your rates due to health conditions.
Portability: Medigap plans are not tied to a specific provider network. This means you can see any doctor or specialist that accepts Medicare, regardless of your Medigap insurance provider.
Types of Medicare Supplement & Medigap Plans
There are different kinds of Medicare Supplement plans, and each covers a specific set of costs. These are the plans that you see labeled Plan A through Plan N. Some of the most notable and common plans are:
Medigap Plan F: This plan offers the most comprehensive coverage, including deductibles, copayments, and coinsurance.
Note:
Plan F is no longer available to those who became eligible after January 1, 2020.
Medigap Plan G: This coverage option covers everything except the Original Medicare Part B (medical) deductible, making it a popular choice for many beneficiaries.
High-Deductible Plan G: This option offers the same benefits as standard Plan G, but with a lower monthly premium in exchange for a higher deductible.
Medigap Plan N: This plan provides a lower premium option but requires some cost-sharing for doctor and emergency room visits.
When & How to Enroll in Medicare Supplement & Medigap Plans
It’s best to enroll in a Medicare Supplement or Medigap plan during your Medigap Open Enrollment Period, which begins the first month you are 65. During this period, you have guaranteed issue rights, meaning you cannot be denied coverage or charged more due to pre-existing conditions.
If you miss this period, you may still be able to enroll in a plan, but you could face higher premiums or be denied due to your health history. To purchase a Medigap plan, you must be enrolled in Original Medicare Part A (hospital) and Part B (medical).
What to Consider When Choosing a Medicare Supplement & Medigap Plan
When selecting a Medigap plan, it’s essential to evaluate all of the benefits, costs, and access to ensure it’s the coverage you need. Here are some factors to consider:
Benefits: Evaluate a plan's extra benefits, such as foreign travel emergency coverage, to identify what matters most to you.
Costs: Premiums for the same plan can vary significantly between insurance companies. Get multiple quotes and compare costs.
Coverage Needs: Decide which costs you’re most concerned about (i.e., deductibles, coinsurance, or copayments) and which plans cover those costs.
Understanding the Difference Between Medicare Supplement & Medicare Advantage Plans
It’s important to know the differences between Medicare Supplement or Medigap plans and Medicare Advantage plans (Part C). Here are some key differences:
Medigap supplements Original Medicare, while Medicare Advantage plans are an alternative to it.
Medicare Advantage plans often include additional benefits such as vision, dental, and wellness programs, but they usually require using in-network providers.
Medigap plans work alongside Original Medicare, allowing you to see any Medicare-approved provider and offering more predictable costs.
Medicare Advantage plans often require prior authorization.