Scott Burge Insurance

Medicare Supplement plans, also known as Medigap plans, are private insurance policies designed to help cover some of the out-of-pocket costs that Original Medicare (Parts A and D.) doesn’t pay for, such as copayments, coinsurance, and deductibles. These plans are offered by private insurance companies and work alongside Original Medicare to provide additional financial protection for beneficiaries. They’re particularly useful for people who want more predictable healthcare costs or who anticipate needing frequent medical services.

There are 10 standardized Medigap plans, labeled A, B, C, D, F, G, K, L, M, and N, each offering a different combination of benefits. The standardization means that, for example, a Plan G from one insurer covers the same things as a Plan G from another, though premiums can vary based on the company, location, and pricing method (e.g., age-based or community-rated). Here’s a quick rundown of what some of the most popular plans typically cover:

- **Plan A**: The most basic, covering essentials like Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used up), Part B coinsurance or copayments, and the first three pints of blood.
- **Plan F**: The most comprehensive, covering all the gaps in Original Medicare, including Part A and B deductibles, excess charges, and foreign travel emergencies. (Note: Plan F is no longer available to new Medicare enrollees as of January 1, 2020, but those enrolled before then can keep it.)
- **Plan G**: Similar to Plan F but doesn’t cover the Part B deductible. It’s become a popular choice for new enrollees due to its broad coverage and slightly lower premiums compared to F.
- **Plan N**: Covers most gaps but requires copays for some doctor visits and emergency room trips, offering a balance between coverage and cost.

A few key points: You need to be enrolled in Original Medicare (Parts A and D.) to buy a Medigap plan—Medicare Advantage plans (Part C) are a separate path and don’t pair with Medigap. Also, these plans don’t cover prescription drugs; for that, you’d need a standalone Medicare Part D plan. Premiums vary widely depending on factors like your age, location, and the insurer, and they’re in addition to your Part B premium.

The best time to buy a Medigap plan is during your six-month open enrollment period, which starts the month you turn 65 and enroll in Part B. During this window, insurers can’t deny you coverage or charge more based on pre-existing conditions. Outside that period, you might face medical underwriting, which could lead to higher rates or denial unless you qualify for a special enrollment circumstance.

Each plan fits different needs—someone healthy might go for a cheaper option like Plan N, while someone with chronic conditions might prefer Plan G for its near-full coverage. It’s a trade-off between monthly premiums and how much you’re willing to pay out of pocket when care happens.