Do Medicare Supplement plans differ for each state?
This article was updated on: 09/16/2018
If you’re thinking of adding a Medicare Supplement plan to your Original Medicare coverage, you may be wondering how it works and whether benefits vary depending on the state you live in. The short answer is, generally no. Most states offer up to 10 Medicare Supplement plans, which offer standardized benefits that are the same across each plan type (labeled A through N), regardless of where you live.
In other words, if Plan F is available in your zip code, every Plan F will have the exact same coverage, no matter which insurance company is offering it (although premium costs may vary). Keep in mind that insurance companies aren’t required to sell every plan type, so the specific plans available in your zip code or county may depend on your location.
What are Medicare Supplement plans?
Medicare Supplement plans (also known as Medigap plans) are offered by private insurance companies and can help you pay for certain out-of-pocket costs not covered under Original Medicare. These out-of-pocket costs can include Medicare deductibles, coinsurance, and hospital or skilled nursing facility costs after you’ve used up your Medicare coverage. Medicare Supplement plans are only available to people who already have Medicare Part A, which helps pay for hospital services, and Part B, which helps pay for medical services. Medicare Supplement coverage only works alongside Original Medicare and can’t be used to pay for Medicare Advantage plan costs.
Which Medicare Supplement plans are available in your state?
Choosing the right Medicare Supplement plan depends on your medical needs and costs. Many beneficiaries with a lot of high out-of-pocket costs may find it useful to fill the gaps in their Original Medicare coverage with a Medicare Supplement plan.
As mentioned, in 47 states, the 10 Medicare Supplement plan options are identified by letters: A, B, C, D, F, G, K, L, M and N. Plan F also offers a high-deductible option. You can refer to the chart at the end of this article for a summary of benefits by Medicare Supplement plan letter type.
Remember, not every plan is available in every location, so it’s important to research plan options for your particular county and zip code. Once you’ve narrowed down the plan type you want, it’s easy to compare insurance companies and premium costs to find the plan that best fits your budget and situation, since coverage will be the same.
Although coverage is the same for each plan letter type, there are a few main differences in the Medicare Supplement plans that insurance companies offer:
- Which plans the insurance company offers. All companies that sell Medicare Supplement plans must offer Plan A, along with either Plan C or Plan F. No insurance company has to offer all 10 standardized Medicare Supplement plans. Some insurance companies may offer extra benefits in addition to the standardized benefits.
- What the insurance company charges for its Medicare Supplement plans (i.e., the monthly premium).
- How the insurance company prices, or “rates,” its premiums. Some companies base the premium cost on your age when you enroll in the plan (known as “issue-age-rated” plans) or your current age (“attained-age-rated” plans). Other companies charge all plan members the same premium, regardless of age (also known as “community-rated” plans).
Because of these factors, it’s a good idea to do research if you’re considering a Medicare Supplement plan, even if the benefits for each plan type are the same. The cost of your Medicare Supplement plan may vary depending on your location, the type of plan you buy, and the insurance company. Always ask the insurance company how it prices its premiums, since this can affect how much you pay for your coverage when you enroll and how much your premium costs may rise in the future.
Medicare Supplement plans vary in some states: Massachusetts, Minnesota, or Wisconsin
- If you live in Massachusetts, you can choose between two Medicare Supplement plan options: Core and Supplement 1. For more information about these plan options, you may visit Medicare.gov or contact the State Health Insurance Assistance Program (SHIP) for Massachusetts at 1-800-243-4636; TTY 1-877-610-0241.
- If you live in Minnesota, you can choose between two Medicare Supplement plan options: Basic Plan and Extended Basic Plan. Some insurance companies also sell optional riders that offer additional coverage for the Basic Plan. Minnesota also has its own state-versions of Plans K, L, M, N, and high-deductible F. To learn more about Minnesota’s Medicare Supplement plans, visit Medicare.gov or contact the Minnesota SHIP at 1-800-333-2433.
- If you live in Wisconsin, you can choose between several Medicare Supplement plan options. One option is the Basic Plan, which covers certain basic benefits, including extra coverage for inpatient mental health services and certain state mandated benefits. In addition, Wisconsin offers “50% and 25% Cost-Sharing Plans,” which are state versions of Plans K and L offered in other states. For additional information, visit Medicare.gov or contact your state SHIP at 1-800-242-1060.
Comparison of Medicare Supplement plan benefits
As mentioned, the same standardized benefits are offered in most states. The chart below lists the benefit features for the Medicare Supplement plans offered in 47 states, excluding Massachusetts, Minnesota, and Wisconsin. Benefits marked with an “X” are 100% covered by the plan. Otherwise, the benefit is covered at the percentage listed.
|Medicare Supplement Plans|
|Medicare Supplement Benefits||A||B||C||D||F*||G||K||L||M||N|
|Medicare Part A coinsurance and hospital costs up to an additional
365 days after Medicare benefits are exhausted
|Medicare Part B copayment or coinsurance||X||X||X||X||X||X||50%||75%||X||X***|
|First three pints of blood||X||X||X||X||X||X||50%||75%||X||X|
|Medicare Part A hospice care coinsurance or copayment||X||X||X||X||X||X||50%||75%||X||X|
|Skilled nursing facility (SNF) care coinsurance||X||X||X||X||50%||75%||X||X|
|Medicare Part A deductible||X||X||X||X||X||50%||75%||50%||X|
|Medicare Part B deductible||X||X|
|Medicare Part B ‘excess charges’||X||X|
|Foreign travel emergency coverage (up to plan limits)||80%||80%||80%||80%||80%||80%|
|Medicare Part B preventive care coinsurance||X||X||X||X||X||X||X||X||X||X|
|Out-of-pocket limits apply**|
*Medicare Supplement Plan F offers a high-deductible version where you pay all Medicare-covered costs until you reach a certain deductible amount for the year. This amount may change from year to year.
**Once you reach the out-of-pocket limits (including the Part B deductible), both Medicare Supplement Plans K and L pay 100% of covered services in the above chart for the remainder of the calendar year.
***Plan N pays 100% of Part B coinsurance costs, except for up to $20 copayment for some office visits and up to $50 for emergency room visits that don’t result in you being admitted as an inpatient.
Hopefully, you now have a better idea of how Medicare Supplement coverage works and the type of plans that may be available in your state. If you want to learn more about Medicare Supplement insurance in your specific location, I would be happy to find plan options that may fit your needs.
- You can use one of the links below to set up a phone call with me or request personalized information from me by email.
- You can also do some research on your own to get familiar with Medicare plan options in your area by clicking on the Compare Plans button on this page.
The purpose of this communication is the solicitation of insurance. Contact will be made by an insurance agent/producer or insurance company.
Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the Federal Medicare program.