How do Medicare Supplement plans work with other Medicare insurance?
Last Updated : 09/16/20186 min read
A Medicare Supplement plan can help pay Medicare’s out-of-pocket costs. It’s useful to know how Medicare Supplement insurance might work with other Medicare health coverage.
Is Medicare coverage enough insurance to protect you from unexpected medical expenses?
If you are a Medicare beneficiary or soon to be one, you may be wondering if Medicare Part A and Part B provide sufficient health insurance coverage to protect you from medical expenses you incur.
Part A generally covers inpatient hospital stays, blood transfusions and hospice care, and Part B may cover doctor visits and preventive services such as annual wellness exams, outpatient diagnostic tests and surgeries, and certain medical supplies and equipment.
While Medicare (Part A and Part B) may cover most of the costs of many health-care services, it does have deductibles and cost-sharing requirements on some services, and places no limit on beneficiaries’ out-of-pocket spending. Because of Medicare’s benefit gaps and cost-sharing requirements, some people with Medicare may look for some form of supplemental coverage to fill some of the gaps in Medicare coverage.
How do Medicare Supplement (Medigap) plans work?
If you decide to stay with Medicare Part A and Part B, instead of receiving your Medicare benefits through a Medicare Advantage plan, you may have the option to sign up for a Medicare Supplement plan. Medicare Advantage plans and Medicare Supplement plans are not designed to work together.
Medicare Supplement (also known as Medigap) plans may help pay for Medicare’s out-of-pocket costs, such as copayments, coinsurance, and deductibles. In addition, some Medicare Supplement plans may cover services not covered by Medicare Part A and Part B, such as emergency care when you travel abroad.
A Medicare Supplement plan may be purchased from a private insurance company licensed to sell the plan in the state where you live. Medicare supplement insurance is available in up to 10 standardized insurance plans. In Massachusetts, Minnesota and Wisconsin different standardized plan options are available. These plans are easy to compare because Plan G, for example, has the same benefits regardless of which insurance company is offering it. The difference is the premium, or cost for Medicare Supplement plan coverage, which varies among insurance companies. You can compare these standardized benefit plans.
Keep in mind that Medigap plans supplement Medicare Part A and Part B; they don’t substitute for Part A and Part B. Like Medicare, a Medicare Supplement plan will pay for covered medical care you receive anywhere in the United States. Also like Medicare, most Medicare Supplement plans help pay the medical costs of any doctor or hospital that accepts Medicare: you don’t have to use a plan’s network of participating health care providers to have coverage. Unlike Medicare, Medicare Supplement plans do not have standardized premiums. Insurance companies that provide Medicare Supplement plans set their own premiums. Another difference between Medicare and a Medicare Supplement plan is that you may not be able to enroll in a Medicare Supplement plan if you drop your plan coverage and want to return to it later or if you wait to enroll in it after the six month period in which you are first eligible for a Medicare Supplement plan (called the Medigap Open Enrollment Period). If you want to sign up later and have a health condition, the Medicare Supplement plan may turn down your application or may charge you a higher premium for coverage.
What if I want more coverage than offered by a Medicare Supplement plan?
Although Medicare Supplement plans are designed to complement Medicare Part A and Part B, there are limitations to their coverage. Unless you purchased (and kept) a Medicare Supplement plan offered before 2006, you won’t be able to get Medicare Part D prescription drug coverage as part of your Medicare Supplement plan. To receive prescription drug coverage, you may enroll in a stand-alone Medicare Part D Prescription Drug Plan offered by a Medicare-approved insurance company that offers its plan in the state where you reside.
Some Medicare Supplement plans might give you the option of adding routine vision, hearing and/or dental insurance coverage. You will pay a separate premium to each private Medicare plan in which you enroll, in addition to your Medicare Part B premium.
Alternatively, you may have the option to enroll in a Medicare Advantage plan. Medicare Advantage plans are offered by private insurance companies contracted with Medicare to provide Medicare beneficiaries their Medicare Part A and Part B benefits (except hospice care, which remains covered under Medicare Part A). Many Medicare Advantage plans offer additional benefits, including prescription drug coverage, dental, routine vision and/or hearing benefits. Keep in mind, however, Medicare Advantage plans Medicare Supplement plans don’t work together.
When is the best time to purchase a Medicare Supplement plan?
If you decide a Medicare Supplement plan is a good choice for your personal circumstances, the best time to enroll in a Medicare Supplement plan is usually during the six-month period that typically begins when you are both age 65 and enrolled in Medicare Part B. This is called the Medigap Open Enrollment Period. During this time period, you cannot be turned down for Medicare Supplement insurance because you are being treated for a health problem and you cannot be charged more for coverage because of your health condition (although you might face a waiting period). Typically your Medicare Supplement plan renews automatically each year as long as you continue to pay your premiums and have Medicare Part A and Part B coverage.
I would be happy to help you learn more about your Medicare coverage and options.
- 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.
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