Original Medicare covers many treatments and services, but it doesn’t cover everything. Medicare supplement insurance, often called Medigap or MedSup, helps people pay some of the health and medical expenses Medicare Part A and Part B doesn’t.
Keep reading to learn more about:
- What Medicare supplement plans cover and don’t cover
- How to compare Medigap plans
- Medicare supplement costs
- How Medigap plans work
What is Medicare supplement insurance?
Medicare supplement plans are private insurance policies that cover some of the bills Medicare Parts A and B don’t cover.
That’s why so many people call Medicare supplement insurance “Medigap” — it fills the payment and coverage gaps left open by traditional Medicare.
For example, all current Medigap plans cover at least a portion of these costs (and most cover them 100%):
- Medicare Part A coinsurance and hospital costs
- Medicare Part B coinsurance or copays
- Medicare Part A hospice care coinsurance or copays
- Costs associated with the first three pints of blood you receive as a hospital inpatient
And some Medigap plans cover:
- Medicare Part A deductible
- Medicare Part B deductible
- Medicare Part B excess charges
- Skilled nursing facility care coinsurance
- Foreign travel emergency care
What doesn’t Medicare supplement insurance cover?
Much like Original Medicare, most Medigap plans don’t cover:
- Dental care
- Eye exams or other types of vision care
- Eyeglasses
- Hearing aids
- Long-term care
- Private-duty nursing
Medigap policies also don’t cover prescription drugs. If you want or need prescription drug coverage, look into a Medicare Part D plan.
What is the difference between Medigap plans?
It can be difficult to compare Medicare supplement plans thanks to the fact that insurance companies sell as many as 10 different types.
This chart can help you tell the 10 Medigap plans apart:
Medicare supplement plans comparison chart
| Medigap benefits | Medigap plan A | B | C | D | F | G | K | L | M | N |
|---|---|---|---|---|---|---|---|---|---|---|
| Medicare Part A coinsurance and hospital costs | 100% | 100% | 100% | 100% | 100% | 100% | 100% | 100% | 100% | 100% |
| Medicare Part B coinsurance or copay | 100% | 100% | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Blood (first three pints) | 100% | 100% | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Part A hospice care coinsurance or copay | 100% | 100% | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Skilled nursing facility care coinsurance | None | None | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Part A deductible | None | 100% | 100% | 100% | 100% | 100% | 50% | 75% | 50% | 100% |
| Part B deductible | None | None | 100% | None | 100% | None | None | None | None | None |
| Part B excess charges | None | None | None | None | 100% | 100% | None | None | None | None |
| Foreign travel emergency care | None | None | 80% | 80% | 80% | 80% | None | None | 80% | 80% |
| Out-of-pocket limit | None | None | None | None | None | None | $5,560 | $2,780 | None | None |
| Source: medicare.gov | ||||||||||
Some insurance companies also sell a high-deductible Medigap Plan F. If you buy it, you have to pay Medicare-covered costs up to the deductible amount — currently $2,300 — before your Medigap plan pays its share.
Also, insurance companies won’t sell Medigap Plan C or Plan F to people new to Medicare after January 1, 2020. This is because Medigap plans can’t cover the Medicare Part B deductible starting on that date.
If you have your eye on Plan F, which many consider the best Medicare supplement plan, but can’t buy it before 2020 begins, get Plan G instead. The only difference between Medigap Plan F and Plan G is that Plan F covers the Medicare Part B deductible.
Do you live in Massachusetts, Minnesota or Wisconsin? The Medicare supplement plans sold in these states are a bit different from those sold elsewhere.
For example, in Massachusetts, insurance companies sell just two Medigap plans. One is called the Core Plan. The other is called the Supplement 1 Plan. Core Plans cover:
- Medicare Part A coinsurance and hospital costs
- Medicare Part B coinsurance
- First three pints of blood each year
- Part A hospice care coinsurance or copay
- 60 days per calendar year of inpatient days in mental health hospitals
- Certain state-mandated benefits, like yearly mammograms
Supplement 1 Plans cover those same basic benefits plus:
- Part A inpatient hospital deductible
- Part B deductible
- Skilled nursing facility care coinsurance
- Foreign travel emergency care
- 120 days per calendar year of inpatient days in mental health hospitals
Medigap plans sold in Minnesota and Wisconsin are standardized in similar ways.
What do Medigap plans cost?
Medicare supplement insurance could cost you as little as $1,300 a year, or about $100 per month, if you buy the most popular type, Medigap Plan F. Or it could cost you as much as $2,000 a year — about $160 per month, according to HealthView Services.
What you pay for a Medigap plan depends on several factors, such as:
- The type of plan you buy
- The company that sells it to you
- Where you live
- Whether or not you’re a smoker
In other words, one insurance company’s Medigap Plan G might cost more than another company’s Plan G. Or it might cost less.
One of the reasons for this is that companies price Medigap plans in three different ways:
Attained-age-rated Medigap plans
Your current age determines the cost of your premium when you buy an attained-age-rated Medigap plan. Because of that, your premiums go up as you get older.
Community-rated Medigap plans
The premiums tied to community-rated Medigap plans aren’t based on your age. Your premiums can still increase over time, though, due to factors like inflation.
Issue-age-rated Medigap plans
Your age when you first buy an issue-age-rated Medigap plan determines its premium. So, the younger you are when you get one, the less it costs.
How does Medicare supplement insurance work?
Here’s how Medicare supplement insurance works after you buy a Medigap plan:
- First, Medicare pays its share of your approved healthcare costs.
- Your Medigap plan then pays its portion — depending on the type of plan you bought.
Where to buy Medicare supplement plans
You buy a Medigap plan from a private insurance company. Before you can buy one, though, you must be enrolled in Medicare Parts A and B.
Also, you pay a monthly premium to the private insurer — not the federal government — to maintain your Medigap coverage.
When to buy Medigap plans
You can buy a Medigap plan at any time. Most people buy Medigap plans during the six-month Medigap open enrollment period, though. This period starts the same month you enroll in Medicare Part B.
If you miss this open enrollment period, you may not be able to find an insurance company that will sell you a Medicare supplement plan. Even if you do, you might pay a lot more for it than you would have if you’d bought it earlier.
Buying more than one Medigap plan
You can’t buy more than one Medigap plan. Also, it’s illegal for an insurance company to sell you a second Medigap plan if it knows you already have one.
Can a Medigap policy cover both me and my spouse?
Medigap plans only cover one person. You and your spouse need to buy separate policies if you both want Medicare supplement coverage.
What is the difference between Medicare Advantage and Medicare supplement?
Medicare Advantage and Medicare supplement plans are very different.
Medicare Advantage plans provide people with all their Medicare Part A and Part B coverage — and usually a bit more. Medigap plans pay some of the costs Medicare Parts A and B don’t cover, like deductibles, coinsurance and copays.
Private companies sell both Medicare Advantage and Medicare supplement plans, but that’s about the only similarity between the two.
What is the difference between Medicare SELECT and Medicare supplement?
Medicare SELECT is a type of Medicare supplement plan sold in some states. Medicare SELECT plans tend to be cheaper than other Medigap plans. They also usually require you to use hospitals and even doctors within a specific network to receive full coverage.
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