How Medicare and Medicare Supplemental Insurance Covers me
Comparing Medigap Plan Benefits | Medicare
Medicare covers a wide variety of things for oldsters. However, there are gaps which regular Medicare does not cover. What if, the country did expand regular Medicare for all? What if, people could buy into Supplemental Healthcare Insurance to cover the gaps (in regular Medicare) at the same prices people on Medicare today can? Would that work at the same cost to many of us using Supplemental today???
Exploring the Medigap Supplemental Plans
I grabbed the chart off of Medicare,Gov as it appears to be more comprehensive than the one at Compare Medicare Plans. The title should be comparing the benefits between Medigap plans..
I have a Plan N Supplemental Medigap plan. It has served me well each time I was either visiting a doctor or hospitalized. I did have United Healthcare which was about 40% more expensive then the Cigna plan (same benefits) we have today. I suggest you shop around as premiums can vary as I learned. My premium is ~$112.00 / month. Jan pays ~$97.00/month. There are copays for doctor visits which are not terribly high ($20?).
Hospitals and Part A expenses are covered anywhere I go in the United States. This is typical for Medigap as compared to Medicare Advantage which may restrict a person to a particular doctor, clinic, or hospital.
Briefly, Charting The Plans
Some general explanation and additional explanation for each Medigap plan can be found in the links. Two of the plans are closed to Medigap new comers. Plan F and Plan C are no longer available to new Medicare enrollees. Plan F and Plan C cover the Part B deductible. Neither are available to those who became eligible for Medicare in 2020 or later.
As you look at the Medigap Plans above, you are probably wondering what the differences are between them. For Part B the maximum a non-participating provider can charge is 115% of the Medicare-approved amount (100% approved + 15% excess).
Below is a list of plans with a brief overview of each plan in the title links. This will go a long way in explaining each plan and what they offer. With each Plan Link, you can compare Medicare Supplement plans and their details. Would similar plans work for the nation as a whole? They could be better than what people have today.
Medigap Plan A
Medigap Plan A offers the most basic of all Medigap plans. Even still, it will cover the 20% that Medicare doesn’t pay for outpatient treatments. That’s arguably the most important piece of all Medigap plans. All Medicare insurance carriers must offer Plan A. However, some states do not require companies to offer it to people under age 65 on Medicare disability.
Medigap Plan B
Medigap Plan B covers everything that Plan A covers but it also picks up the Medicare Part A hospital deductible. Plan B is a Medigap plan that pays after Medicare pays. Don’t confuse it with Part B, which is part of your Original Medicare benefits that pay for outpatient medical.
Medigap Plan C
Medigap Plan C is one of the most comprehensive supplements. It covers everything except Medicare excess charges. This means it pays both your deductibles and the 20% that you would normally owe toward all outpatient expenses. Medigap plans C & F are very popular.
Medigap Plan D
Plan D covers most things but does not pay the Part B deductible nor any Medicare excess charges. This makes it one of the least popular Medigap plans. Don’t confuse it with Part D, which is your drug coverage – two different things.
Medigap Plan F
Medigap Plan F has long been the most popular selling Medigap plan in the Medicare Supplement world. It covers ALL of the items that you would normally pay for. It leaves you with nothing out-of-pocket for covered services. Many people enjoy the peace of mind that comes with knowing you won’t even owe a copay for doctor visits or hospital stays.
There is also a high-deductible version of Plan F that provides great Medigap coverage after you meet a deductible first.
Medigap Plan G
Medigap Plan G has been gaining in popularity in recent years. It covers everything that Plan F does except for the Part B deductible. Premiums for Plan G are often very competitive, which can often make it a better value than Plan F. When we compare Medicare Supplements between Plan F and G in most states, we often find that Plan G is a better value annually.
Medigap Plans K, L, and M
These plans offer partial coverage of certain benefits. For instance, Plan K covers 50% of most items and Plan L covers 75% of most items. All three of these plans are rarely requested by Medicare beneficiaries, so not all carriers offer them. However, you can often find good Medicare Supplement rates for these plans in certain areas.
Medigap Plan N
Medigap Plan N was created in 2010. It offers lower premiums in exchange for you paying copays for certain things like doctor and emergency room visits. It also does not cover the Medicare excess charges. The lower premiums are attractive to many beneficiaries, but we sometimes find that policyholders find the small bills for excess charges to be annoying.
However, Plan N covers 100% of the Medicare Part A inpatient hospital deductible ($1,736 per benefit period in 2026). It also covers Part A coinsurance, making your hospital deductible responsibility $0.
Competitive?
Many people discuss Medicare for all. I doubt they are talking about this type of healthcare as Medicare for all. If a family of four had a Plan N policy at $112.00/month per individual, would this work? There are gaps in Plan N. However, the plan does cover many things which may not be accessible in regular healthcare insurance or regular Medicare. It is basically gap coverage.
You would still need regular Medicare. The Medigap plans cover what is missing in regular Medicare. Something to review, read and thing about in passing .. .
“Compare Medigap Plan Benefits,” Medicare
“Medicare Supplement Plan | Medicare Supplemental Insurance,” Medigap
I retired last year, and after much looking over the Medicare Advantage plans and Part C (Medigap), came to the same conclusion you did – Medicare Advantage may be right for a small fraction of the population, but otherwise, just… no. I went with Plan N, as I am immune to annoyance at small charges, and so did my wife (who was a high-end RN who worked in Critical Care and Intensive Care for decades before retiring last year herself). So we’re both Medicare A, B, C, and D.
It’s a pity about the whole Vietnam War thing, for many reasons, one (very minor one) of which is that without it, LBJ would probably be recognized as a top-five President.
John:
I am a Vietnam era veteran who served in the Marine Corps 68-71. I left a Sergeant and went to NYC to see about a girl in 71, She said “yes.” Long time ago and we were young at 22 and 20.
I think I have been writing about healthcare for over a decade. Other writers such as Maggie Mahar were at Angry Bear also. I believe she grew tired and left the writing scene. A loss for us as she knew more than I did on the topic.
When I retired 12 years ago, we had to make a choice then. I had seen how Advantage was directing people and taking advantage of them one locked in their program. Medicare has its issue; but, we can take it anywhere for sure. Our Plan N Supplemental is with Cigna this year. It was a large reduction in cost over our old plan with United Healthcare. Part D is with WellCare. They pay everything so far with very little for us to pickup.
I was at Lejeune for two years drinking the water and showering in it. I have a blood disorder where my platelets take a vacation for a couple of weeks at a time. The Hematologist wrote a Nexus which blamed my affliction on the water at Camp Lejeune. Since 82, I have had bouts.
For once someone said the “why” it is occurring. There was more than just Vietnam impairing us today. They do take care of me and pay for my care.