If you are enrolling in original Medicare, getting a supplemental policy ("Medigap insurance") is a smart decision because it will help pay for things that are not covered by Medicare. Medigap insurance policies may cover copayments, coinsurance and the Part A deductible. Here are some tips to help you choose an appropriate plan.
In all but three states (Massachusetts, Minnesota, and Wisconsin), Medigap plans, which are sold by private health insurers, are available to new enrollees in eight different standardized plans. These plans are labeled with the letters A, B, D, G, K, L, M and N, with two more, C and F, which are only available to those eligible for Medicare before 2020.
Plan G is the most popular policy among new enrollees because it is the most comprehensive range of coverage. Monthly premiums for Plan G typically range between $100 and $300, depending on your age and the state you reside in. If that is more than you are willing to pay, there are also high-deductible plans that have lower premiums but impose higher out-of-pocket costs.
For more information on the different types of plans and coverage details, including Medigap options in Massachusetts, Minnesota, and Wisconsin, go to Medicare.gov/publications and type in "choosing a medigap policy" in the keyword box, and download their 2022 guide. You can also call 1-800-MEDICARE and ask them to mail you a copy.
How to Choose
To pick a Medigap policy that works best for you, consider your health, family medical history and your budget. The differences among plans can be small and rather confusing.
To help you choose, visit Medicare.gov/medigap-supplemental-insurance-plans and type in your ZIP code. This will give you a list of the plans available in your area, including the price range, name and contact information of companies that sell them. To get specific pricing information, you will need to contact the carriers directly or call your State Health Insurance Assistance Program.
It is required by law that Medigap policies with the same letter must cover the exact same benefits, you should shop for the cheapest policy.
You will get the best price if you sign up within six months after enrolling in Medicare Part B. During this open-enrollment period, an insurer cannot refuse to sell you a policy or charge you more because of your health.
Medigap policies are usually sold as either: "community-rated" where everyone in an area is charged the same premium regardless of age; "issue-age-rated" that is based on your age when you buy the policy, but will only increase due to inflation, not age and "attained-age-rated," that starts with low premium but increase as you age. Community-rate and issue-age-rated policies are the best options because they will save you money in the end. You can buy the plan directly from an insurance company or you can work with a reputable insurance broker.
You should also be aware that Medigap policies do not cover prescription drugs, so if you do not have drug coverage, you will need to buy a separate Medicare Part D drug plan too. See Medicare.gov/plan-compare to compare plans. Also, note that Medigap plans do not cover vision, dental care, hearing aids or long-term care.
Instead of getting original Medicare, plus a Medigap policy and a separate Part D drug plan, you may want to consider a Medicare Advantage plan (see medicare.gov/plan-compare) that provides all-in-one coverage. These plans, which are sold by insurance companies, are generally available through HMOs and PPOs that require you to get your care within a network of doctors.
Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.