Do you want a simple way to budget your Medicare healthcare costs?
With a Medigap policy, you will know exactly how much you will spend on your Medicare out-of-pocket costs.
A Medigap policy is also know as a Medicare Supplement Plan. If you choose to keep Original Medicare and you choose to buy a Medigap policy, you will keep all the freedoms offered by Original Medicare.
You will be able to go to ANY Doctor or Hospital ANYWHERE in the United States that accept Original Medicare. You do NOT have to ask anyone for any referrals or anything like that. You are free to choose your quality of care.
Let's looks at your options & How they work
There are 12 Medicare Supplement Insurance (Medigap) plans that are available. These plans are labeled Plan A, B, C, D, F, G, K, L, M, N, HG & HF
Please don’t let that confuse you, most of these plans are not available in all areas or they are plans that you would never want to buy anyway. I’ll explain after the chart below.
When you are looking at the chart below, the percentage that you see in the boxes are what that Medigap plan will pay towards the amount that Medicare did not pay.
Plan F and Plan G both offer high deductible plans. These two plans work the same way as the others but they have a deductible of $2,370 in 2021. That means you have to pay all your medical bills until you have spent $2,370 in 2021.
The tradeoff for you having to pay that deductible is that these plans have a low monthly premium, these high deductible plans are perfect for people who don’t really use healthcare services but still want financial protection if something bad should happen.
What Happened to Plan C & F in 2020?
Medigap Plan C & F will not be available to people who become eligible for Medicare on or after January 1, 2020.
Plan F and Plan C are not ending, however. If you already had Medicare before Jan 1st, 2020 you can still buy Plan C & F and If you already had Plan C or Plan F, you will be able to keep your plan. This change only applies to people who started Medicare on or after Jan 1st, 2020.
This is because of the MACRA Law which was passed by congress. It basically says that after Jan 1st 2020, no new Medicare beneficiary can buy a plan that covers the Part B deducible.
Most people need to only look at plan G, HG or N. These are the most popular plans and the only once that make financial sense.
Average Premium is between $150 – $220
Plan G is one of the more popular ones because it covers the Part A deductible & the 20% coinsurance from Part B & any Part B co-payments or access charges. Skilled Nursing coinsurance, first 3 pints of blood and and additional 365 days of coverage after Medicare Part A benefits are used up. The only charge that it does NOT cover is the $203 yearly Part B deductible. You also have 80% coverage outside the country if you are on vacation.
Premium: $100 – $140
This plan covers everything that Plan G covers except Part B excess charges and you might have a $20 doctors office visit charge.
The access charge means that some doctors want to charge you more than Medicare gives everyone else, so you could be responsible for the extra charge. But this is easily avoidable because you can just ask if the doctor takes Medicare as full payment. Problem solved and most doctors don’t do this.
The HG stands for High Deductible G, it covers everything that the regular Plan G covers AFTER you pay a $2340 deductible. So you have to pay the first $2340 in medical bills before this plan will start paying. This is a great plan for healthy people because if you don’t really use medical services you will save a lot of money. This plan is not available everywhere since it’s so new, check with your local Insurance Agent for availability.
Can anyone with Medicare buy a Medigap Insurance policy?
No, not everyone can buy a Medigap policy. When you become first eligible for Medicare, you get a 6 month Open Enrollment Period. During this time you can buy any Medigap policy that is available in your area.
Once that period has passed, you will have to qualify to be able to buy a Medigap policy. That means you have to do medical underwriting. The insurance company can and will decline you if you can’t qualify.
There are a few other options that might get you qualified if you have medical conditions that will decline you normally. If you are outside your Open Enrollment Period, you may be able to enroll in another Medigap policy if you have “guaranteed issue” right’s.
Some situations may qualify you for guaranteed issue rights:
1. Your plan committed fraud or mislead you.
2. Your Medigap plan went bankrupt
3. You dropped your Medigap plan to use your trail right to try a Advantage plan. Less then a year has passed and you want to switch back.
4. Your Medigap plan stops providing care in your area.
5. You moved out of your Advantage plans service area.
6. You elected to keep your employer based coverage and now that plan is ending.
What to do Next?
If you are interested in a Medicare Supplement plan, you first need to schedule an appointment so that we can figure out if it’s even a options for you. If you are able to buy one, we need to figure out if you will need to answer medical questions, and if so, if you can qualify.
For general questions please send us a message...
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