Medicare Supplement Plan Advantages

Posted: October 25, 2023

Medicare is a popular health insurance option for older adults, with 18.4% of the U.S. population choosing Medicare coverage. As an older adult, you know how critical health care is for your peace of mind and quality of life. Medicare supplement plans can be a significant advantage in helping you navigate gaps in your Medicare coverage.

There are many reasons to choose a Medicare Supplement plan, and many options to suit your unique lifestyle and requirements. Before you decide whether a supplement plan is right for you, it’s best to understand your options and what benefits you can expect.

What Is a Medicare Supplement Plan?

Medicare Supplement health insurance — or Medigap — is additional insurance you can purchase from a private health insurance company. As the name suggests, it helps you fill your coverage gaps in your policy by paying toward your portion of out-of-pocket costs in Medicare. In other words, supplemental health insurance lets you go beyond your primary medical coverage and seek the treatment you need, knowing you have that extra support.

If you are 65 or older, have a qualifying disability and have Original Medicare — parts A and B — you qualify for a supplement policy. When you claim, Medicare pays its share of the approved amount. Then, Medigap pays its portion, so you’re only responsible for the remaining amount.

What Does a Medicare Supplement Plan Cover?

Aside from the occasional exception, Medicare Supplement plans cover some or all of the following medical expenses:

• Medicare A coinsurance and hospital costs up to one year after your Medicare benefits are used.
• Medicare B coinsurance and copayment.
• The first three pints of blood.
• Hospice care coinsurance or copayment.
• Medicare Part A and B deductible.
• Medicare part B excess charge.
• Skilled nursing facility care coinsurance.
• Foreign travel exchange.

Depending on your chosen plan, you may receive some or all of the above benefits. However, there are some services not covered by most Medigap plans, including the following:

• Vision and eyeglasses
• Dental
• Hearing aids
• Private-duty nursing
• Long-term care

What Is the Difference Between Medicare Advantage and Medicare Supplement

As an older adult, you have several medical insurance options. Medicare Supplement is different from Medicare Advantage — also known as Part C — in several ways, and it’s essential to understand these differences so you can make the right decision for your circumstances and lifestyle.

Medicare Supplement provides coverage in addition to the Medicare program coverage you already receive. Medicare Advantage combines Medicare Parts A and B into one plan for comprehensive coverage and often includes Part D prescription medication coverage.

Some of the significant differences between these two plans include:

• Medicare Parts A and B hospital coverage: Medicare Advantage provides this coverage. Medicare Supplement does not, but offers out-of-pocket expense coverage in addition to your hospital coverage.
• Medicare Part D prescription medication coverage: Medicare Advantage often includes prescription drugs. Medicare Supplement does not, but you can purchase separate coverage.
• Out-of-pocket expenses: These additional costs are only covered by Medicare Supplement.
• Provider network: With Medicare Supplement, you can choose any doctor or hospital that accepts Medicare. You have a more limited provider network on Medicare Advantage. Still, you can select additional doctors and hospitals on some plans at an additional cost.

Why Choose a Medicare Supplement Plan?

There are 43.1 million people in the United States with more than one type of health coverage. For many, additional coverage puts their minds at ease about any significant medical expenses that may arise. Medicare Supplement is one of those options, as it helps reduce your costs by covering what Original Medicare does not. There are several reasons Medicare Supplement could be the right option for you, including the following:

• You require care or treatment when traveling out of state.
• You want to stay with a Medicare-approved health care provider of your choice.
• You want to know you have help paying for the medical costs not covered by Original Medicare.

You want a reliable health plan you can trust that is flexible enough to suit your lifestyle. For example, Medicare Supplement could be valuable if you want benefits like copayment coverage and the ability to see a doctor of your choice in the comfort of your home or a specialist without a referral.

Who Should Get a Medicare Supplement Plan?

You are eligible for Medicare Supplement if you are 65 or over, or you’re under 65 and have a specific disability that leaves you unable to work for at least a year. Such disabilities include certain forms of cancer, respiratory illnesses and musculoskeletal disorders. A Medicare Supplement plan is an excellent choice if you are eligible, would like help covering your out-of-pocket medical expenses and value having more freedom of choice in managing your health.

The Advantages of a Medicare Supplement Plan

You may be wondering whether it’s necessary to pay for additional insurance on top of your Medicare Original plan. There are many reasons why a Medicare Supplement plan could come in handy when you need help the most. Some Medicare Supplement plan benefits include:

1. Freedom of Choice

Many insurance providers offer several options within Medicare Supplement, so you can choose the price and coverage that suits you most. In addition, Medicare requires all insurance companies to provide similar benefits for each plan — marked by a letter of the alphabet. If you choose Plan G, for example, you’ll get the same benefits regardless of your choice of provider.

You also have greater freedom of choice of doctor or hospital. Suppose a health care organization accepts Medicare insurance. In that case, they accept Medicare Supplement plans, so you can go directly to the health care provider you choose without waiting for referrals or pre-approval.

2. Peace of Mind

Your Medicare Supplement plan works with Medicare Parts A and B to reduce your share of health care costs. With this coverage, even unexpected medical events have less impact on your financial health, and you have peace of mind, knowing you can receive the treatment you need.

3. Opportunity to Cover 100% of Your Out-of-Pocket Costs

Plan F offers the most significant benefits of all the Medicare Supplement plans. If you choose plan F, you can rest assured you won’t be required to pay any out-of-pocket expenses provided Medicare approves the benefits. If, for example, you need additional tests, your insurance plan covers 100% of these costs, relieving you of the stress and financial burden of copayments on any Medicare-approved health services.

4. Immediate Coverage

There is no waiting period for preexisting conditions, and your provider will pay your benefits from the moment you’re covered. Your policy is also renewable. It renews provided you pay your premiums on time and represent yourself truthfully.

5. Coverage for Travelers

Medicare Supplement plans are an excellent option if you regularly travel nationwide. You can receive treatment with the hospital or doctor of your choice anywhere in the United States and receive the same coverage. Medicare will also cover 80% of your emergency healthcare services when you travel outside the country.

6. Additional Benefits

Depending on your chosen plan, your Medicare Supplement plan could offer additional benefits, like an AAA membership with 24/7 roadside assistance, vision and hearing aid benefits and a quarterly allowance for over-the-counter medications. In addition, you could also have access to fitness and wellness programs.

Medicare Supplement Plan Options

If you’re considering a Medicare Supplement plan, you have several options. They are represented by letters A, B, C, D, F, G, K, L, M and N. Each option has its advantages and limitations, but Plan F is the most popular, with 41% of Medicare Supplement Insurance enrollees choosing this option. Plan G is also a standard option, serving 32% of enrollees.

Your Medicare Supplement plan options include the following:

• Supplement Plan A: This is like a starter-level supplement plan. If something is covered in Plan A, most other plans will also cover it. Supplement Plan A covers Medicare Part A coinsurance and hospital costs for as long as an additional year after your Medicare Part A benefits are exhausted. This plan also covers your Original Medicare Part B coinsurance or copayment, the first three pints of blood and your Original Medicare Part A hospice care coinsurance or copayment.
• Supplement Plan B: This plan offers an additional benefit to Plan A — coverage for Original Medicare Part A deductible.
• Supplement Plan C: This plan is no longer available for those who qualified for Medicare on or after January 1, 2020. It’s a comprehensive option if it’s still available but doesn’t cover excess charges — healthcare professional charges over the Medicare-approved amount.
• Supplement Plan D: Not to be confused with Medicare Part D, this plan is one of the most detailed options available if you turn 65 on or after January 1, 2020. It’s almost a replacement for Plan C and covers all the same things besides the Part B deductible.
• Supplement Plan F: This is the most popular plan, so it makes sense to look at what it covers. Plan F is the most comprehensive Medicare Supplement plan, covering all the above benefits and skilled nursing facility care coinsurance, Parts A and B deductible, Part B excess charge and 80% of care during overseas travel. However, Plan F is only available if you turned 65 before January 1, 2020. Those already on this plan will experience no changes. Still, if you’re exploring your options today, you’ll have to choose something other than plan F.
• Supplement Plan G: This plan is similar to Plan F and is still available today. It offers the same coverage as Plan F aside from the Part B deductible. Plan G is already a popular option, and as Plan F phases out, it will only become more popular due to its wide range of coverage.
• Supplement Plans K and L: Both these plans cover a fraction of your costs until you reach your out-of-pocket limit. They are less comprehensive than some of your other options, with plan K covering 50% and plan L covering 75% of coinsurance and copayment costs until you reach your limit.
• Supplement Plans M and N: These plans are similar to Plan D and cover many of the same charges. Plan M covers 50% of your Part A deductible. Plan N covers 100% of the Part B coinsurance, except a copayment of up to $20 for a portion of your office visits and $50 for hospital visits.

Which Medicare Supplement Plan Is Right for You?

One of the great things about Medicare Supplement plans is you can choose how and where to boost your Original Medicare coverage. Consider the following points to help you make the right decision:

• Plans A and B: These are relatively inexpensive but provide minimal coverage.
• Plans K and L: These options are also great if you’re on a limited budget but do come with an out-of-pocket maximum.
• Plans F and C: Choosing one of these plans gives you access to the most comprehensive plan options. They are almost identical, but plan C doesn’t cover your excess. Both of these options are being phased out.
• Plans G and D: These plans will replace plans F and C, with one significant difference — neither covers the Part B deductible.
• Plans M and N: These options offer similar coverage to plan D but are less comprehensive and provide less coverage for some expenses.

These plans remain the same regardless of your chosen insurance provider, so you can discuss your options with them and find one that best suits your needs and budget.

How to Apply for a Medicare Supplement Plan

The best time to apply for a Medicare Supplement plan is when you’re in your six-month open enrollment period — month one is when you’re 65 and enrolled in Medicare Part B. Although you may be able to purchase a supplement plan after this period has elapsed, it’s not guaranteed and may be more expensive.

The application process is quick and straightforward. Just follow these simple steps:

• Focus on benefits: Decide which benefits you value the most, and examine the different supplement plans available to you to determine which best suits your needs and preferences.
• Consider your health: It may be challenging to switch plans, so consider your family history and choose a plan that covers some more likely eventualities.
• Choose and insurance company: Medicare Supplement plans are covered by private insurance companies, which means you’ll pay your premiums to your private insurance company and continue with your Medicare Original premiums as usual. Research different private insurance companies to provide a trustworthy option that suits your requirements.
• Request a quote: Contact your chosen insurance provider and request a quote. They will be in touch with you to finalize the purchase of your chosen plan.

Medicare Supplement Plan Enrollment Tips and Tricks

Choosing the right Medicare Supplement Plan can be challenging. The following tips, tricks and reminders can help simplify the process:

• You must enroll in Medicare Part A and B to qualify for a Medicare Supplement plan.
• Most Medicare Supplement plans don’t include prescription drug coverage. You can purchase additional plans to help with this, such as Medicare Part D. Some private insurance companies offer Medicare Part D, and you may need to make separate payments.
• Medicare supplement plans cover a single person, so you and your spouse must purchase a policy each.
• Standardized plans are renewable even if you experience health changes.
• All plan benefits are the same across the country, but the costs of each plan vary in different states.

Get Your Medicare Supplement Plan Through Health for California

Let choosing and applying for a Medicare Supplement Plan be a breeze with help from Health for California. We’ve been helping California residents apply for health coverage since 2004, and we pride ourselves on our fast, easy and accurate online application process — the quickest and easiest way to apply for health insurance in the state. In addition, you have free access to our agents, who are always available to help you navigate the world of health insurance and answer any of your questions.

Our agents can help you compare plans, calculate government subsidies, and choose coverage that meets your needs. Contact us today to speak to an agent, or shop for your ideal plan online.