10 Things To Know About Medicare Supplemental Health Insurance

Medigap Plans can be confusing. Even though Medicare covers most of your medical bills after you turn 65, there are some serious gaps in the coverage. To avoid this from happening Medicare supplemental policies called, Medigap can cover most of those costs.

Trying to make sense of which one to buy is the issue. There are different coverages, and prices for those extra benefits. It can be confusing. At the end of the day, everyone wants to get the best care, with the best options, for the least amount of money. The experts at AARP have developed a guide to help clarify a few things to know about Medicare and buying Medigap coverage:

1.) Deductibles - Expect to pay a certain amount out of pocket every year before Medicare Part A and Part B coverage kicks in $1,600 for Part A if a patient is admitted to the hospital and $226 for Part B in 2023.

It's important to know you’ll still have to pay a portion of the costs for doctors’ services, medical equipment, long stays in either a hospital or nursing home, outpatient care, and other services.

2.) Copayments - The set fee you pay for any health service you use, such as $25 for a doctor's visit.

3.) Plans If You Don't Plan To Visit A Hospital Or Nursing Homes - A and B cover routine costs, but don't cover things like nursing home coinsurance ($200/day after 20 days.

4.) The Worst Plans - Medicare's most popular - A, K, L, M. The Medicare Part A Hospital deductible is $1,600. It is paid with every new hospital admission. Plan M pays half and plans K and L cover a percentage until you reach the out-of-pocket limit.

5.) A big plus for Medigap - In contrast to private Medicare Advantage plans, with Medigap coverage, you can use any doctor or hospital that accepts Medicare.

6.) These Plans Are Cheap, But Read The Fine Print - These plans usually have lower monthly payments but high deductibles.

7.) Plans With More Comprehensive Coverage - C, F, and O (if available) - These plans usually have a higher premium but cover most of Medicare cost-sharing. C and F will your annual Part B deductible ($226 in 2023) pay. G does not.

8.) Plans That Provide Coverage For Less Money - D and N. D plans cover just about everything that C, F, and G do, except for Plan B excess charges that some doctors charge. They do not cover the Part B annual deductible either. With Plan N it's $20 for most doctor victims and there is a $50 copay for some ER room visits.

9.) Plans That Are Sensible For Chronic Health Conditions - C, D, F, G, and N all have good coverage for doctor visits, lab tests, hospital stays, and extended stays at nursing homes.

10) When can I buy a Medigap policy? - There are no time restrictions. You can buy a Medigap policy anytime after signing up for Medicare Part A and Part B. Medigap plans have no annual open enrollment period like Medicare Part D and Medicare Advantage plans. But Medigap insurers can reject you or charge more because of preexisting medical conditions unless you apply at certain times.

The best time to buy a Medigap policy if you’re 65 or older is within the six-month period that starts the first day of the month you enroll in Medicare Part B. During this time, insurers must offer you all the Medigap policies available in your area at the best rates for your age. You also have several guaranteed issue rights, which means that you can buy a Medigap policy regardless of your health and under specific situations.

State laws differ. Your state may also have other periods when you can buy Medigap policies without any health questions. Where you live can make a difference.