Medicare Supplement Plans, sometimes referred to as “Medigap Plans,” are designed to pick up some or, all of the costs that Original Medicare does not cover. Some examples of these costs would be Part A or Part B deductibles, skilled nursing facility co-pays, and the 20% co-insurance for Part B services.
There are 10 basic plan designs outlined by the National Association of Insurance Commissioners (NAIC) that, in most states, are represented by the letters
A,B,C,D,F,G,K,L,M, and N. In addition to these, some states also allow the sale of a “high deductible Plan F.”
Medicare Supplements are regulated by individual states. Each state determines which plans will be made available in that state. In turn, carriers wishing to do business in that state will pick from the approved list which plan types they wish to offer for sale. All carriers selling in any given state must offer at least Plan A. If the carrier wishes to offer any plans other than Plan A, it must offer at least either Plan C or Plan F.
Medicare Supplements are an attractive option to many seniors.
Some of the more attractive features are:
- Most comprehensive coverage– Plan F which is most popular plan, leaves very little, if any, cost share to the consumer.
- No Provider Networks – Enrollees can see any provider in the US who accepts Medicare.
- No Primary Care Physician required– This also means that PCP referrals are not required.
- Consistency– Although the NAIC occasionally reviews and adjusts the plan benefits, this is not a common occurrence. The plan designs and benefits do not normally change from year to year.
Important To Know:
None of the Medicare Supplements sold today include Prescription Drug Coverage. A person who chooses to enroll in a Medicare Supplement will need to purchase a stand-alone Medicare Prescription Drug plan in order to meet their “creditable coverage” requirement.
Medicare Supplements do not provide coverage for services that are not considered eligible Medicare expenses. A couple of exceptions to this would be that some plans (C,D,F,G,M, and N) provide Foreign Travel Emergency coverage for those traveling outside of the US. (Medicare itself does not cover services outside of the US.) Another example would be that some companies may offer “non-medical” value added services such as discount programs for eyewear, 24 hour nurse help lines, gym membership discounts, etc.
For more information about Medicare Supplement Plans in your state, please call us at 800-234-9488.