What are Medicare Supplement plans (Medigap plans)?

There are differences between Medigap and Medicare Advantage plans, but one isn’t inherently better; the choice depends on individual healthcare needs and preferences.

Medigap plans (Medicare Supplement plans) work alongside Original Medicare Part A and Part B. These plans pay for some or all of the out-of-pocket costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. You must enroll in a standalone Medicare Part D prescription drug plan when enrolled in a Medigap plan.

Medicare Advantage plans provide a substitute for Original Medicare Part A and Part B coverage, with equal coverage and benefits. These plans usually offer additional benefits like dental, vision, hearing, and prescription medication coverage. If your prescription drug coverage is included in your Medicare Advantage plan, it is called Medicare Advantage Prescription Drug plans. In that case, you would not need to enroll and pay for a Medicare Part D plan.

Medigap plans (Medicare Supplement plans) cover the Medicare-approved out-of-pocket costs from Original Medicare Part A and Part B. Depending on the plans that are available to you and that you choose, these costs could include copayments, coinsurance, deductibles, and more.

Medigap plans generally don’t cover vision, dental, hearing, and other benefits that can be included in Medicare Advantage plans.

Neither a Medigap plan (Medicare Supplement plan) nor a Medicare Advantage plan is better – it’s about finding the plan that fits your health and budget needs.

Medicare Advantage Prescription Drug plans often include prescription drug coverage and sometimes benefits such as dental, vision, hearing, and more – but they come with network restrictions. Medigap plans offer a wider choice of doctors and hospitals than Medicare Advantage plans, but they often come with higher monthly premiums. They don’t provide the dental, vision, hearing, and other benefits that many enjoy with a Medicare Advantage plan.

To decide which plan type is best for you, consider your current healthcare utilization, budget, and preferred level of flexibility. These can help you narrow down which plan type best suits your needs.

Medigap (Medicare Supplement) coverage is designed to help pay for some or all of the Medicare-approved out-of-pocket expenses of Original Medicare, such as copayments, coinsurance, deductibles, and more. Because out-of-pocket costs can add up quickly, especially if you have a significant accident or illness, a Medigap plan can provide substantial financial relief.

The top 5 Medicare Supplement (Medigap) plans depend on your needs. There isn’t a best plan. Instead, your plan should be tailored to your health and budget needs. However, based on enrollment, Medicare Supplement Plan F, Plan G, and Plan N are the three most popular plans in many states.

If you became eligible for Medicare before 2020, you could still enroll in Plan F. If not, Plan G is the closest plan. The only difference is that it doesn’t cover the Part B deductible. Plan N is similar to Plan G but requires cost-sharing for some services. Plan N is often the more affordable option between Plan G and N. To find the right plan, speak with a local, licensed Connie Health agent.

You don’t “need” supplemental insurance with Medicare, but it is advised. With Original Medicare Part A and Part B alone, there is no cap on out-of-pocket expenses, which could leave you vulnerable to high out-of-pocket costs or medical debt.

Suppose you don’t have a lot of savings to be able to pay for a severe accident or illness out-of-pocket. In that case, it’s recommended that you enroll in either a Medicare Supplement (Medigap) or Medicare Advantage plan. A Medicare Advantage plan caps your out-of-pocket expenses, making your costs more predictable, while a Medigap plan pays for some or all Medicare-approved healthcare costs that your chosen plan covers.

The “best” Medicare Supplement plan (Medigap plan) is subjective because it depends on your needs. Three popular plans are most commonly enrolled in. These include Medicare Supplement Plan F, Plan G, and Plan N. You may want to add these to your list for consideration.

Plan F or Plan G might be your best choice if you’re seeking predictability in healthcare costs with the most comprehensive coverage. If you’re more cost-conscious regarding the monthly premium and don’t mind paying some out-of-pocket expenses, Plan N may better suit your needs.

Speaking with a local, licensed Connie Health agent can help you determine which Medicare Supplement plans available in your state are best for your health and budget needs.

The primary differences between Medicare Advantage and Medicare Supplement are how they complement Original Medicare, provider networks, benefits, and costs.

Medicare Advantage plans offer equal coverage to Original Medicare Part A and Part B without working with Original Medicare. These plans also often have narrower networks than Medicare supplement plans. However, Medicare Supplement plans don’t cover comprehensive and routine dental, vision, hearing, and prescription medications.

Medicare Supplement plans work with Original Medicare Part A and B to pay for some or all of the Medicare-approved out-of-pocket expenses. These plans have a more extensive network and are suitable for people who travel and may need to see a physician or specialist out of state. However, they don’t provide extra benefits like Medicare Advantage plans, and you must purchase standalone Medicare Part D prescription drug coverage. Generally, Medicare Supplement plans tend to be more expensive.

The Medicare Supplement Open Enrollment Period (Medigap Open Enrollment Period)  is unique to you. It begins the first day of the month when you are 65 or older and enrolled in Original Medicare Part B. This is the best time to enroll in a Medicare Supplement (Medigap) plan because you can’t be denied coverage or charged more because of preexisting or current medical problems.

Maybe. If you want to change your Medicare Supplement plan, it’s likely outside of your Medigap Open Enrollment Period. During this period, you have guaranteed issue rights that enable you to enroll in any Medigap plan of your choice without being penalized for pre-existing conditions.

Suppose you want to change your Medicare Supplement plan outside your Medigap Open Enrollment Period and have a pre-existing condition. In that case, you may be denied or face higher premiums if accepted.

Neither a Medicare Advantage nor a Medicare Supplement plan is better, but they do offer different benefits, and it comes down to your health and budget needs. Medicare Advantage plans often offer lower monthly premiums and may offer additional benefits like routine dental, vision, and hearing care, plus prescription drug coverage. However, they also typically have more network restrictions.

A Medicare Supplement plan works to cover some or all of your Original Medicare out-of-pocket costs, which makes spending more predictable. These supplemental plans offer great provider flexibility – you can see anyone who accepts Medicare. However, they don’t offer the extra benefits; you’ll need to purchase separate prescription drug coverage, and they often have a higher monthly premium.

Yes, you can apply for a Medicare Supplement plan at any time. However, you may not be able to enroll. If you apply for a Medicare Supplement plan (Medigap plan) during your six-month Medigap Open Enrollment Period, then you have a guaranteed issue right that enables you to enroll in any available plan.

If you apply outside your Medigap Open Enrollment Period, you’ll need a Special Enrollment Period. For example, you could qualify for a Special Enrollment Period if you lose employer coverage. To learn whether you’re in your Medigap Open Enrollment Period or have other Medicare Supplement questions, call and speak with a local licensed Connie Health agent who can help.

If you apply for a Medigap plan outside your Medigap Open Enrollment Period or Special Enrollment Period, you won’t have guaranteed issue rights. Insurance companies might deny coverage or charge you more.

Yes, you might be able to change from Medicare Advantage to a Medigap plan. There are instances when this is possible, but timing is critical. The best time to change from a Medicare Advantage to a Medigap plan is during your Medigap Open Enrollment Period. This is when you have guaranteed issue rights; therefore, you can’t be denied Medigap enrollment.

You can also choose to disenroll from your Medicare Advantage plan and return to Original Medicare during the Annual Enrollment Period or Medicare Advantage Open Enrollment Period. However, if these times don’t coincide with your Medigap Open Enrollment Period, you could be denied Medigap enrollment due to preexisting conditions or charged more.

You can also make plan changes during a Special Enrollment Period. Call and speak with a local licensed Connie Health agent to learn more about whether you can make a plan change in your particular situation. They’ll let you know your options.