What To Know About Medicare Supplemental Insurance


The basic Medicare program, sometimes referred to as original Medicare, offers some of the most robust insurance options for seniors. Unfortunately, Medicare is also one of the more confusing insurance programs. Original Medicare is divided into multiple categories, known as parts. Each part provides different coverage, such as focusing on inpatient hospital care or prescription drugs. To add to the confusion, some plans are offered through the federal government, while others are from private insurance companies.

If you combine Medicare plans, you get coverage for most of your medical needs, but even with multiple plans, there are some gaps. One of the ways you can fill these gaps is by purchasing Medicare Supplement Health Insurance, also known as Medigap.

Understanding Medicare Supplemental Insurance Plans

In order to purchase a Medicare Supplemental Insurance plan, you must have either Medicare Part A or B. Unlike the standard Medicare plans, Medigap coverage only applies to an individual and does not extend to family members. Supplemental plans are also separate from the standard Medicare plans, so the two plans have different premiums, deductibles and copays.

Medicare Supplemental Insurance is divided into multiple plans, also known as parts. Like the original Medicare plans, there are Parts A-D. Supplemental insurance has even more plans, including parts F, G, K, L, M and N. Most of these plans provide the same basic coverage, with small differences. Having so many parts may seem confusing, but it allows you to better customize your insurance options, so you are not spending extra on features you do not need.

Additionally, not all states offer the same Medicare Supplemental Insurance plans. If you are unsure where to purchase supplemental plans, you can use a free online search tool provided by the federal government to look up insurance providers and plans in your state.

Medigap insurance coverage is accepted by the majority of doctors, hospitals and medical specialists. If your doctor normally accepts original Medicare insurance, your supplemental plan should be compatible. This allows you to keep the same doctor or health specialists if you decide to sign up for a supplemental plan after signing up for original Medicare coverage.

Reasons to Purchase Medicare Supplemental Insurance Plans

There are several ways Medicare Supplemental Insurance assists you. For most seniors, the biggest appeal of purchasing a Medigap plan is to cut down on out of pocket expenses from the original Medicare Part A and B. With the original Medicare insurance, you are required to pay any costs after your initial deductible out of pocket. When you are finished with the deductible from your original plan, your supplemental insurance activates and provides coverage for any future coinsurance or copayments you owe.

Medicare Supplemental Insurance also has long-term benefits. Under original Medicare A and B, you only get limited coverage for hospital or skilled nursing facility visits. For many seniors, the number of days needed to recover from surgery or other rehabilitation services exceeds the limited coverage offered by Medicare. In these situations, your only option is to pay out of pocket, which is quite expensive, or risk your health by leaving early.

Supplemental insurance provides extra time in rehabilitative facilities, as well as covering expenses for hospice care. All of the supplemental plans have coverage for hospice care. With the exception of Parts A and B, all Medigap plans help with skilled nursing facilities. Parts K and L offer limited coverage for nursing facilities, only covering 50 and 75 percent of the costs.

Original Medicare coverage does not extend outside of the United States. Medigap plans C, D, F, G, M and N all offer 80 percent coverage for medical expenses in a foreign country.

Purchasing a Medicare Supplemental Insurance Plan

You can purchase Medicare Supplemental Insurance during the traditional Medicare enrollment period. The first period is open enrollment, which always starts on October 15th and goes until December 7th. After open enrollment, your next option to apply for a supplemental plan is during the general enrollment period. General enrollment opens at the start of a new year and runs until the end of March.

Applying for a supplemental insurance plan is different beyond the first open enrollment period, which officially begins when you turn 65 years old. If you do not purchase a supplemental plan after the first enrollment period, the private insurance company has the option to deny or increase your supplemental costs based on your medical history. Insurance providers also have the option to not sell a plan beyond your first enrollment period.

Companies Selling Medicare Supplemental Insurance

There are different companies selling Medicare Supplemental Insurance in each state. A few of the largest private insurance companies offer supplemental plans all across the United States. The cost of plans largely varies depending on where you live. Additionally, companies may change the eligibility requirements depending on where you apply. Some companies also exclude certain supplemental plans, so you may have to shop around with different providers to find the best plan for you. If you are unsure where to start, consider some of the largest insurance companies, such as: