Medicare Supplement plans, also known as Medigap, are health insurance policies sold by private insurance companies. Medicare Supplements are designed to be paired with Medicare Parts A and B to “fill in the gaps” that Medicare does not cover (like copays, coinsurance and deductibles). Many individuals like Medicare Supplements because they can help protect you from high medical expenses and you rarely receive bills. However, you will likely pay a higher monthly premium for a Medicare Supplement than you will for a Medicare Advantage plan.
With Supplements, coverage from both Medicare and the Supplement work together. In other words, Medicare pays its share of approved covered health care costs and sends the remaining balance to the individual’s insurance company. The Supplement will pick up some or all of the remaining costs.
Because Medicare Supplements do not offer Part D benefits, those on a Supplement need to enroll in a stand-alone Medicare Part D prescription drug plan or another form of creditable drug coverage (meaning coverage equal to or greater than Medicare’s minimum standards of coverage). If you chose not to pair drug coverage with your Supplement, you could be charged a Late Enrollment Penalty (LEP) the next time you try to sign up for a drug plan.
Medicare Supplements do not include routine dental, vision or hearing benefits. However, having additional coverage can help alleviate potentially high out-of-pocket costs and ensure you are able to receive the medical services you need. Those on Supplements have the option to purchase stand-alone coverage benefits if they choose. We recommend considering which stand-alone options would be beneficial to you based on your individual needs.
Many health insurance companies sell Medicare Supplements. However, each plan can vary in levels of coverage and cost. Medicare Supplement plan benefits and costs can also change each year, but unlike Medicare Advantage plans, these changes are not tied to Medicare’s open enrollment. Rather, these changes are unique to your plan and insurance company. While the majority of Supplement enrollees receive minimal bills for health care expenses, beneficiaries do pay a monthly premium in addition to their Part B premium.
Supplement plans differ from Medicare Advantage (MA) plans in their benefit structure and the way that they cover health care. MA plans are a way for you to receive your Medicare Part A, Part B, and sometimes even Part D benefits all in one plan. A Supplement plan only supplements these benefits—meaning you must receive your Part A, Part B, and Part D benefits through another source. Medicare Advantage plans feature “networks,” meaning you typically have a set list of doctors and facilities you can visit and still receive insurance coverage. Medicare Supplements do not have networks, allowing you to visit any doctor, hospital, or facility, as long as they accept Medicare.
If you are not a RetireMed client yet, we would be happy to answer your questions and discuss how we can help you! Please call our team of local advisors at 937.915.3563.
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