How Do I Know If I Need a Medicare Supplement Plan? – Frequently Asked Questions

Steven Mott by Steven Mott | Licensed since 2012
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This article was updated on: 10/29/2018

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Medicare Supplement insurance plan is one option you may have to work alongside your Medicare Part A and Part B coverage. But do you need it?

What is a Medicare Supplement plan?

Medicare Supplement plans are sold by private insurance companies. They’re designed to help cover some of Original Medicare’s out-of-pocket costs. You need to be enrolled in both Medicare Part A and Part B to buy a Medicare Supplement (Medigap) plan.

What Medicare Supplement plans may cover

Different Medicare Supplement plans may help pay for Medicare Part A and Part B coinsurance, copayments, and/or deductibles. There are up to 10 standardized Medicare Supplement plans available in 47 states. Massachusetts, Minnesota, and Wisconsin have their own standardized plans.

For example, each standardized Medicare Supplement plan (with names ranging from Plan A to Plan N) may cover Part A inpatient hospital care (coinsurance and hospital costs) for 365 days after your Medicare benefits have expired. Each of these plans may also cover at least part of your Medicare Part B coinsurance or copayments. Take a look at what each of the standardized Medicare Supplement plans may cover.

Do you need a Medicare Supplement plan?

Only you can decide if you need a Medicare Supplement plan. You might want to take a look at how much you usually spend on health care, including Medicare out-of-pocket costs if you already have Medicare. If you generally have (or expect to have):

  • Many doctor visits every year
  • Frequent hospitalizations
  • Medicare Part B coinsurance or copayments for Medicare-approved durable medical equipment or supplies

…then you might want to add up your out-of-pocket costs – including deductibles – for Part A and Part B and compare them to what you’d pay for a year of Medicare Supplement insurance. Keep in mind:

  • Some Medicare Supplement plans may pay Part A and/or Part B deductibles, but others don’t.
  • Some Medicare Supplement plans may themselves have deductibles to pay.

There are other things you might want to consider when figuring out if you need a Medicare Supplement plan. For example, Medicare Supplement Plans K and L have maximum out-of-pocket limits. This means that if your Medicare out-of-pocket spending reaches a certain amount, and you’ve paid your Medicare Part B deductible, the plan may cover all your Medicare-covered services for the rest of the year.

This is a lot to think about, isn’t it? If you’d like some help understanding Medicare Supplement insurance and weighing it against other Medicare plan options, I’d be happy to assist you.

  • Would you like to set up a phone call with me, or have me email you some customized Medicare plan options? Just follow the links below.
  • To see what Medicare Supplement plans are available in your area with no obligation, click the Compare Plans or Find Plans buttons on this page and enter your zip code.

The product and service descriptions, if any, provided on these Medicare.com Web pages are not intended to constitute offers to sell or solicitations in connection with any product or service. All products are not available in all areas and are subject to applicable laws, rules, and regulations.

Medicare has neither reviewed nor endorsed this information.

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