It’s no secret that senior health insurance can be a tricky topic to understand. But it’s easier when it’s broken into steps. Step 1 is deciding whether you’re going to sign up for Original Medicare or purchase a private Medicare Advantage plan. Step 2 is researching what are the best supplemental health insurance options for retirees and choosing which ones are right for you, so you'll be well protected.
Medicare Supplement insurance — also called Medigap because it helps fill in the gaps of Medicare coverage — helps you cover potentially expensive out-of-pocket costs, like coinsurance, copayments, and deductibles.
Medicare Supplement insurance isn’t owned or operated by the U.S. government, but it's private insurance that must follow rules set by the government. Medicare Supplement insurance plans differ from one another in what costs they help cover, how they are paid for, and who can purchase them. With 10 standardized Medicare Supplement insurance plans available, you’ll need to decide which is best for you.
This is the most basic Medicare Supplement insurance plan. It covers Medicare Part A coinsurance and hospital costs, the first three pints of blood, and Part A hospice care coinsurance or copayment. It also covers 20% of the Part B costs that Medicare doesn’t cover. However, people with this insurance plan are required to pay their Medicare Part A and Part B deductible.
Plan B is very similar to Plan A. It also covers all the same things that Plan A covers, plus the Medicare Part A deductible. People with this insurance plan are still required to pay their Medicare Part B deductible.
Medicare Supplement Plan C covers the Medicare Part A coinsurance and hospital costs, Part B coinsurance or copayment, the first three pints of blood, Part A hospice care coinsurance or copayment, skilled nursing facility care coinsurance, Part A and Part B deductibles, and 80% of foreign travel exchange up to plan limits. It is only available to individuals who turned 65 prior to Jan. 1, 2020, because of Medicare Access and CHIP Reauthorization Act (MACRA).
Plan D is very similar to Plan C. It covers all the same costs that Plan C covers, except people who purchase this insurance plan are responsible for their Medicare Part B deductible.
Plan F covers all out-of-pocket costs and coinsurances that Medicare doesn’t, but it is only available to individuals who turned 65 prior to Jan. 1, 2020, because of MACRA. Plan F also has a high-deductible version. It includes all the same coverage as the original Plan F, but it has a higher deductible to lower the monthly premium costs.1
This insurance plan covers nearly the same costs as Plan F, except the insured is responsible for paying their Medicare Part B deductible up front. Like Plan F, Plan G has a high-deductible version that includes all the same coverage as the original Plan G, but it has a higher deductible to lower the monthly premium costs.1
Plan K covers 50% of most benefits, including Medicare Part B coinsurance or copayment, the first three pints of blood, Medicare Part A hospice care coinsurance or copayment, skilled nursing facility care coinsurance, and the Medicare Part A deductible, coinsurance, and hospital costs. People who purchase this insurance plan are responsible for the Medicare Part B deductible. Plan K has an out-of-pocket limit of $6,940 in 2023, which means the Medicare Supplement plan will pay for 100% of covered services for the rest of the calendar year after you meet that limit and the yearly Part B deductible.
Like Plan K, Plan L doesn’t cover benefits entirely. It covers 75% of Medicare Part B coinsurance or copayment, the first three pints of blood, Part A hospice care coinsurance or copayment, skilled nursing facility care coinsurance, and the Medicare Part A deductible. Like Plan K, it covers the Medicare Part A coinsurance and hospital costs in entirety, and people who purchase this insurance plan are responsible for the Part B deductible. Plan L will have an out-of-pocket limit of $3,470 in 2023, which means the Medicare Supplement plan will pay for 100% of covered services for the rest of the calendar year after you meet that limit and the yearly Part B deductible.
Plan M helps cover Medicare Part A coinsurance and hospital costs, Part B coinsurance or copayment, the first three pints of blood, Part A hospice care coinsurance or copayment, skilled nursing facility care coinsurance, and 50% of the Medicare Part A deductible. It also covers 80% of foreign travel exchange up to plan limits.
Plan N is sometimes called the copay plan. It pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to $50 for emergency room visits that do not result in an inpatient admission. It also covers Medicare Part A coinsurance and hospital coverage, the first three pints of blood, Medicare Part A hospice care coinsurance, skilled nursing facility coinsurance, the Medicare Part A deductible, and 80% of foreign travel emergency up to the insurance plan limits.
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Kelly Rayburn, AVP national sales and distribution at Wellabe, and Olga Villaverde, from Lifetime TV’s The Balancing Act, discuss what Medicare Supplement insurance is and how it differs from Medicare Advantage.
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