Medigap Plans

Advantages of Medigap

Medigap plans offered by the Health Insurance Companies provide you with other great advantages:

  • You can see any doctor participating in Medicare, which gives you access to a huge range of providers!
  • Regardless of which insurance company you bought your Medigap plan from, the Medicare-accepting doctor will accept it.
Medigap Plan A
  • Basic Medigap plan
  • Covers the 20% on outpatient treatments unlike Medicare
  • If you are under age 65 and qualify for Medigap due to a disability, you may purchase this plan during your open enrollment period (OEP) without underwriting
  • If you are UNDER age 65, you might be paying 3 times more for Medigap A as compared to someone 65 and over.
Medigap Plan B
  • Coverage of Plan A
  • Also covers Medicare Part A hospital deductible, so you won’t be paying as much as $1,316 or more
  • Pays the deductible multiple times in the same year
  • The rate you pay for the same benefits can differ from Insurance Company to company, based on zip code, age, smoking, gender, and household discounts
Medigap Plan C

Don’t confuse this with Medicare Part C!

  • Coverage of plans A and B
  • Doesn’t cover Medicare excess charges
  • The excess charges are surcharges that can go 15% beyond what Medicare pays
Medigap Plan D
  • Covers the gaps in Medicare, including the 20% outpatient charges
  • Does not cover the deductible
  • Does not cover Medicare excess charges
Medigap Plan F
  • Covers all the gaps in Medicare, including deductibles and copays
  • Switching your F carrier means you will have to answer health questions (underwriting)
  • The rate you pay for the same benefits can differ from Insurance Company to company, based on zip code, age, smoking, gender, and household discounts
  • There is also a special version of this plan called a High Deductible Plan F. This plan often includes very, very low monthly premiums coupled with protection from high out of pocket costs, by an Annual Maximum Out of Pocket, which is set annually by the Internal Revenue Service. With this plan, you can often save a thousand or more dollars a year in those years where you do not require many expensive medical procedures while preserving your ability to see ANY doctor, ANYWHERE, as long as they accept Medicare.
Medigap Plan G
  • Covers everything that Plan F does, except for the Part B deductible ($183)
  • It pays for your hospital expenses during hospital stays, including the $1340 deductible
  • Most outpatient care, except for the first $183
Medigap Plan K
  • Offers lower premiums with higher cost-sharing with the Insurance Companies.

  • You would be paying parts A and B deductibles but you might also get an extra year in the hospital

  • Covers all the same basic benefits

Medicare Supplement Plan K – Capped Out-of-Pocket Charges
The limit is set at $4,960, which is how much you might be paying annually. Any more than the cap and the insurance policy will be covering the rest of your expenses for the year.

  • Also pays for preventive care services
Medigap Plan L
  • Offers reduced premiums for 75% of your medical expenses covered by your insurance carrier
  • You will also be paying the Medicare Part B deductible and surcharges

Capped Out-of-Pocket Charges
The limit is set at $2,480, which is how much you might be paying annually. Any more than the cap and the insurance policy will be covering the rest of your expenses for the year.

Medigap Plan M
  • Cover the basics like other supplements do
  • You pay lower monthly premiums
  • You also pay full annual outpatient and half of the hospital deductibles
Medigap Plan N
  • With this Medicare Supplement plan, you pay lower premiums
  • Plan covers the 20% Medicare doesn’t, hospital deductible, copays, and coinsurance
  • Cost-sharing increases, such as $20 of doctor copay and $50 for an Emergency Room visit

What Medigap Doesn’t Cover

Medicare Supplement plans do not cover the following:

  • Retail prescription drugs
  • Dental exams
  • Eyeglasses
  • Contacts
  • Vision exams
  • Hearing aids and exams
  • Long-term/custodial care

Open Enrollment Period (OEP)

Beginning on the first day of your birth month, or when you have enrolled in part B, the OEP lasts for 6 months. Since you are buying your supplemental Individual Health Insurance during OEP, you:

  • Won’t have to answer any medical questions
  • Be denied insurance due to health conditions
  • Not be charged an additional amount
  • Purchase the Medicare supplemental plan of your choice
  • Don’t mistake the Annual Election Period for the OEP. The former is for
  • Medicare Part D while the latter is for your Medigap plan.

Guaranteed Issue Window

Medicare supplement guaranteed issue rights make you eligible to purchase certain Medigap policies within 63 days of losing your group coverage after retirement. The guaranteed issue window is a shorter time span than the OEP but it works in the same way.

You may choose between Plans A, B, C, D, G, F, K, L, M and N.

IF moving out of state results in losing your Medicare Advantage coverage, you can avail your guaranteed issue right to apply for it in the new state.

Keep the notices from your former insurance carrier safe since they prove creditable coverage or you might be charged the Part D late enrollment penalty.

Underwritten

If the time for both OEP and guaranteed issue has passed and you need Medicare supplement, you can purchase it after passing an underwriting. For that, you will have to answer some health questions, giving the insurance company the right to decline you.

The Annual Drug Election Period is NOT the time you can change supplement without underwriting. It is related to Medicare Advantage and drug plans.

Get Your Free Copy of the “Ultimate Guide to Medicare” video and eBook from Florida Medicare Agency!

This book helps you learn about the different parts of the Medicare program, including Medicare Part A and Part B (together, they are often called “Original Medicare”), Part C (often called “Medicare Advantage”) and Part D (the part of Medicare that covers your prescription medications).

Sign Up For Medicare

We understand that Medicare matters can get quite complicated. It is better to get help understanding Medicare before you sign up for a plan. With our help, you will have in-depth health insurance knowledge of the benefits offered by basic and supplement plans. Call 754-205-2005 right away for your Health Insurance Quotes!

This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.

Florida Health Agency is a licensed health insurance agency certified to sell Medicare products.
Medicare has neither reviewed nor endorsed this information.

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