Medicare Supplement Plans: What They Cover and How They Work

Understanding Medicare Supplement/Medigap Plans

Our Medicare Supplement/Medigap service is designed to provide you with the peace of mind that comes with knowing your healthcare costs are covered, even when Original Medicare falls short. Our private health insurance options help to fill in the gaps, covering coinsurance, copayments, or deductibles, and reducing out-of-pocket expenses.

We believe that everyone deserves access to high-quality healthcare, regardless of their financial situation. And our team of experienced professionals is dedicated to providing comprehensive healthcare plan navigation, helping you identify the best options for your unique needs and budget.

We aim to help you achieve optimal health outcomes while minimizing your healthcare expenses. With our Medicare Supplement/Medigap service, you can rest assured that you will receive the care you need when you need it without having to worry about the associated costs.

What does a Medicare Supplement plan cover?

To put it simply, if you have Original Medicare and a Medicare Supplement plan, you’ll be covered for most of your healthcare costs. While Original Medicare typically covers about 80% of your hospital, doctor, and physician fees, you’re left to pay the remaining 20% in coinsurance, copayments, and deductibles. However, with a Medicare Supplement plan, Medicare will pay its portion of the Medicare-approved amounts for your covered healthcare costs, and your Medigap policy will pay its share, reducing your out-of-pocket costs significantly. Essentially, if Medicare covers a specific service or procedure, your Medicare Supplement plan will cover it as well.

What are the different Medicare Supplement plans?

Ten Medicare Supplement plans are available, identified by the letters A, B, C, D, F, G, K, L, M, and N. These plans are standardized by Medicare, meaning that every insurance company must adhere to the same guidelines. As a result, the benefits offered by each plan are identical across all companies, with the only variance being the cost. So, regardless of which insurance provider you choose, you can expect the same level of benefits from each plan.

How does a Medicare Supplement plan work?

A Medicare Supplement plan covers the gaps in coverage left by Original Medicare. After receiving medical care, your provider (whether a hospital or doctor) will bill Medicare. Medicare will then pay its portion of the bill (usually 80%), and your Medicare Supplement plan will cover the remaining coinsurance gap. Your specific Medicare Supplement plan may cover all or a portion of the 20% coinsurance gap. Since Medicare Supplement plans are standardized, it doesn’t matter which insurance company you purchased your plan from – the coverage will work the same way. In short, your provider bills Medicare, Medicare pays its share, and your Medicare Supplement plan covers the remaining cost.

What is not covered by a Medicare Supplement plan?

Medicare Supplement plans generally do not cover long-term care, retail prescription drugs, dental or vision care, hearing aids, glasses, or private duty nursing. It’s important to note that while Medicare Supplement plans help fill the gaps in coverage left by Original Medicare, they don’t provide coverage for everything. However, as previously mentioned, if you’re covered by Original Medicare, you’ll also be covered by your Medicare Supplement plan.

The following types of coverage are not considered Medicare supplements:

1. ✓ Medicare Advantage Plans (also known as Part C), such as HMOs or PPOs.
2. ✓ Medicare Prescription Drug Plans (Part D).
3. ✓ Medicaid.
4. ✓ Employer or union plans, including the Federal Employees Health Benefits Program (FEHBP).
5. ✓ TRICARE.
6. ✓ Veterans Benefits.
7. ✓ Long-term care insurance policies.
8. ✓ Indian, Tribal, and Urban Indian Health Plans.
9. ✓ Qualified health plans are sold on the health insurance marketplace.

It’s important to note that while these plans may provide health care coverage, they are not Medicare supplements and operate under their own separate rules and guidelines.