A Medicare Supplement Plan is private insurance that helps pay the “gap” between what’s paid by Original Medicare and what’s not. It covers things like deductibles, coinsurance, and co-pays.
IMPORTANT – if a medical service is not covered by Medicare, it will not be covered by your Medicare Supplement plan.
Another name for Medicare Supplement is Medigap supplemental insurance or Medigap insurance.
You must have Original Medicare Part A (hospital) and Part B (medical) in order to purchase a Medigap plan. You cannot purchase a Medigap plan if you have Medicare Part C (Medicare Advantage).
Medigap plans do not cover prescription drugs. You must have a Prescription Drug Plan (Part D) to cover your prescription medication.
Initial Enrollment for Medicare Supplement (Medigap) Plans
Your initial enrollment period for Medigap coverage begins on the first day of the month you are 65 and enrolled in Medicare Part B. The enrollment period runs for 6 months.
If you purchase Medigap coverage during your initial enrollment period, there is no medical underwriting. This means you cannot be denied coverage or charged extra for health reasons.
However, after your initial enrollment period, you will be required to complete a medical questionnaire to buy or change plans.
Therefore, we recommend you:
- Purchase Medigap coverage as soon as you are first eligible.
- Select the best coverage you can afford.
- Choose a carrier you can trust.
After all, most people have the same Medigap coverage for life.
Jonathan Katz and his team at Virginia Medical Plans rank number one out of all Anthem’s producers of Medicare Supplement plans in the state of Virginia. He has helped 1000’s of individuals ensure they are fully covered once enrolled in Medicare Part B.
Jonathan Katz and his team at Virginia Medical Plans rank number one out of all Anthem’s producers of Medicare Supplement plans in the state of Virginia. He has helped 1000’s of individuals ensure they are fully covered once enrolled in Medicare Part B.
Types of Medicare Supplement (Medigap) Coverage
All Medigap policies must adhere to federal and state laws. They are standardized according to their benefits. This is true regardless of the issuing insurance company.
Standardized Medigap plans are identified by the letters A through N. Each policy with the same letter must offer the same basic benefits, no matter which insurance company sells it.
| Medigap Benefits | A | B | C | D | F* | G* | K | L | M | N |
|---|---|---|---|---|---|---|---|---|---|---|
| Part A Co-Insurance & Hospital Costs (up to 365 additional days after Medicare benefits are used up) | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
| Part B Coinsurance or Copayment | Yes | Yes | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes*** |
| Blood (first 3 pints) | Yes | Yes | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes |
| Part A hospice care coinsurance or copayment | Yes | Yes | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes |
| Skilled Nursing Facility Care Coinsurance | No | No | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes |
| Part A Deductible | No | Yes | Yes | Yes | Yes | Yes | 50% | 75% | 50% | Yes |
| Part B Deductible | No | No | Yes | No | Yes | No | No | No | No | No |
| Part B Excess Charges (a doctor's charges above Medicare's approved amount) | No | No | No | No | Yes | Yes | No | No | No | No |
| Foreign Travel Exchange (up to plan limits) | No | No | 80% | 80% | 80% | 80% | No | No | 80% | 80% |
| Out of pocket limit** | N/A | N/A | N/A | N/A | N/A | N/A | $4940 | $2470 | N/A | N/A |
* Plans F and G also offer a high deductible plan. On a high deductible plan, you must pay for Medicare-covered costs up to the deductible amount of $2,800 in 2024 before your Medigap pays anything.
** After you meet your out-of-pocket yearly limit and your yearly Part B deductible, the Medigap plan pays 100% of covered services for the rest of the calendar year.
*** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in inpatient admission.
The only difference between Medigap plans with the same letter sold by different insurance companies is typically the cost.
So when choosing Medigap coverage, it is important to select a reliable insurance carrier and shop around for the best price.
Plan F (and High Deductible F) is available only if you were Medicare-eligible prior to 1/1/2020.
If your Medicare start date is 1/1/2020 or later, we suggest Plan G or, where available, High Deductible G. We would be happy to help you choose a plan that makes sense for you.
Please give us a call at 703-707-8270!
