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Medicare Supplemental Plans

Medicare Supplemental plans are plans that fill in the “gaps” in original Medicare Parts A and B. These supplemental plans are designed to work with Medicare itself. They are offered through private insurance companies. While it can certainly be overwhelming to compare and choose among the many plan options, it is to your advantage to understand Medicare Supplemental insurance so that you make the selection that is right for you.

Here are some important facts to know about the plans:

FACT #1: Medicare Supplemental insurance plans are standardized.

First and foremost, the plans are Federally-standardized. What this means is that it is relatively easy to compare the different plan options. You are comparing “apples to apples”. The plans go by the standardized plans chart, which can be viewed here: Medigap Coverage Chart. And, each company must go by this chart.

What this means is that a Medigap Plan F with one company is the exact same as a Plan F with another company. Plan F is the most comprehensive plan, and it is also the most common. However, some of the other plans, including Medigap Plan G and Medigap Plan N, provide comprehensive supplemental coverage, at a lower monthly premium cost.

To understand the differences in the plans, you can easily review the coverage chart. NO Medicare supplemental insurance plans cover medications, so that is not listed on the chart at all. The plans do, however, cover things that Medicare covers. The easiest way to think of it is that, if Medicare covers it, the supplemental plan will fill in the “gaps”. But if it is something that Medicare doesn’t cover (i.e. dental, experimental procedures, etc.), the supplemental plan likely will not cover it either.

FACT #2: You CAN enroll at any time but there are certain times that you SHOULD enroll.

There are no annual enrollment periods for Medicare supplemental plans – this is a common misconception. The Part D drug plans do have an annual enrollment period, which has probably led to the development of the belief that you can only change, or enroll in, a supplement plan during this certain time of the year. You can, however, enroll in a plan at any time.

That said, you DO have to answer medical questions (in most cases) when you enroll in a Medicare Supplemental insurance plan UNLESS you are in an “open enrollment” or “guaranteed issue” situation.

Some of the most common occurrences of one of these situations are:

If you fall into one of these (or several other) open enrollment or guaranteed issue situations, you can enroll in a Medicare Supplemental plan without having to answer any medical questions, pay a higher rate because of pre-existing conditions, or be denied coverage based on your health. Because of that, these are the optimum times to enroll in a plan. If you are in one of these situations, you are well-advised to take advantage and enroll at that time.

FACT #3: You can go to any doctor or hospital with any of the Medicare Supplemental insurance plans.

Unlike with most employer coverage plans, or Medicare Advantage plans (the other type of Medicare insurance), you can go to any doctor or hospital, nationwide, with a Medicare supplemental insurance plan. There are no networks. These plans are NOT PPOs or HMOs and there are no provider directories or referrals required.

As long as the provider takes Medicare itself, which is your primary insurance, they are required to take the standardized Medicare supplement plans.

This also means that, because the plans are nationally-standardized, if you move from one state to another, you do not necessarily have to change your insurance plan.

FACT #4: Medicare Advantage plans are NOT the same as Medicare supplemental plans.

As previously mentioned, Medicare Advantage plans are the other type of Medicare insurance. These are commonly confused with Medicare supplemental plans, and many people make the problematic mistake of lumping supplemental plans and Advantage plans together. This could NOT be any further from accurate.

Medicare Advantage plans actually take the place of Medicare A & B. All of your benefits are provided through the private company. They are NOT supplements. They pay INSTEAD of Medicare.

Medicare Supplemental insurance, on the contrary, pays AFTER Medicare pays. They do not replace Medicare, but rather, “supplement” it.

There are many other coverage differences, which you should certainly explore if you are deciding between the two options. The most basic differences, though, are the way they pay (above), doctor accessibility, and co-pay structure.

Medigap Insurance Plans

Medicare Supplement (Medigap) plans are Federally-standardized. Not all plans are offered by all companies, but the plans that are offered are:

Companies Offering Medicare Supplemental Insurance

Nationwide, there are numerous options for Medicare Supplement insurance. Out of all those options, though, the key is finding companies that are both competitively-priced and highly-rated. The companies below all operate in multiple states, some nationwide, and are both highly-rated and competitively-priced: