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Choosing a Medicare Policy
Your Medigap Options
NOTE: your Medicare Card does not have any network designations: no HMO/PPO – that is because Original Medicare offers nationwide coverage and flexibility see any provider, any specialist, any facility that accepts Medicare. NO referral required. The Medigap plans supplement Original Medicare, so they offer the same flexibility to see providers of your choosing. Medicare Supplement/Medigaps plans are health insurance policies that offer STANDARDIZED benefits to work with Original Medicare. They are sold by private insurance companies and depending on which plan you choose will pay for parts or all of certain remaining costs NOT covered by Medicare. A Medigap plan have different levels of coverage – one may cover deductibles & copays whiles another may also cover coinsurance-you will need to take you time in choosing the plan that work best for YOU. Medigaps may also cover health care costs that Medicare does not cover at all, like care received when travelling abroad. **Remember, Medigaps only work with Original Medicare – so if you have a Medicare Advantage Plan, you can NOT buy a Medigap-and it is ILLEGAL for an agent to sell you one!!
Depending on where you live, you may have up to 10 different Medigap policies to choose from: A, B, C, D, F, G, K, L, M, and N –always look at current Medicare & YOU book for updated plans. Each Medigap policy offers a different set of standardized benefits, meaning that policies with the same letter offer the same benefits. FOR Example: a Plan G –will offer the EXACT set of standardized benefits - no matter the insurance company, but NOTE: premiums will vary from company to company.
Medigap plans are Guaranteed Renewable and have no “annual enrollment period” requirement. Plans renew month after month - each time premiums are paid. If you pay monthly, they are renewed monthly-if you pay quarterly, they renew quarterly. The end of the year’s “Annual Enrollment period” is NOT for your Medigap plan and there is NO ACTION you need to take to renew your Medigap policy –except continue to pay premium on time. Medigap carrier cannot drop you from your plan or make changes to your plan because of any changes in health. So there is much confidence in these type of plan!!
Medigap Plans
This chart shows basic information about the different benefits that Medigap policies cover. If a percentage appears, the Medigap plan
covers that percentage of the benefit, and you must pay the rest.
* Plan F is also offered as a high‑deductible plan by some insurance companies in some states. If you choose this option, this means you
must pay for Medicare‑covered costs (coinsurance, copayments, deductibles) up to the deductible amount of $2,300 in 2019 before your
policy pays anything.
**For Plans K and L, after you meet your out‑of‑pocket yearly limit and your yearly Part B deductible ($185 in 2019), 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 an inpatient admission.