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Navigating Medigap Coverage Levels: What Each Plan Offers

Medicare covers many medical expenses, but it doesn’t cover everything. That’s why 23% of Medicare enrollees have a Medigap policy to pay for the remaining costs, such as copayments and deductibles. But there are a lot of options for Medicare supplement coverage, and the prices can vary widely. Fortunately, there are ways to help you determine which plan is best for your unique situation and budget.

In addition to being standardized, Medicare Medigap Coverage Levels Supplement plans are sold by insurance companies and can have premiums that vary by company, plan, and region. Plan premiums are generally higher for those with more comprehensive coverage, as well as those who have been enrolled in the Medicare Advantage plan.

For this reason, you should always compare quotes before purchasing a Medicare Supplement policy. You can use the online Medicare Compare tool to see what the available premiums are for different health insurers and plans in your area. It’s also important to know that you can only get a Medigap policy if you have both Parts A and B of original Medicare, or if you are a beneficiary in a Medicare Advantage plan. If you’re unsure whether your Medicare Advantage plan is considered traditional Medicare or if it’s a Medicare Advantage HMO, you can contact the Medicare Part D provider to find out.

Choosing the right Medigap policy can be a complicated decision, but a knowledgeable agent can make the process much easier. They can explain how the different policies work, including what benefits each provides and what costs you may incur. They can also give you an idea of how the premium will change over time, so you can plan accordingly.

One thing that might be confusing for some is that the letter designations of each plan mean nothing. All the plans are standardized, so an A or F plan sold by one insurer covers the same things as any other A or F plan from another insurer.

Another factor that affects your premium is how you were rated. You can be community-rated or attained age-rated. A community-rated policy has a set monthly rate that doesn’t increase as you age, while attained-age rating means your premium will go up as you get older.

It’s also important to remember that if you have been in a Medicare Advantage plan or an employer health insurance for six months, the insurer or the independent insurance agency that sells you the Medigap policy can refuse to cover your pre-existing conditions. However, if you buy the policy during your open enrollment period and have had continuous “creditable coverage,” or a similar health plan, for that same six-month period, the insurer is required to cover those pre-existing conditions. This is an exception that’s a benefit to most beneficiaries, as it helps them avoid a costly surprise. For more information about this, contact your state’s Department of Insurance.