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Do I need a Medigap plan with Original Medicare?

Do I need a Medigap plan with Original Medicare?

One common decision most Americans need to make when they become eligible for Medicare at 65 is whether to sign up for a Medigap (Medicare Supplement) plan to help cover the medical costs that Original Medicare doesn’t cover. The gaps left behind by Original Medicare are significant, leaving Medicare beneficiaries to pay for the remaining 20% of costs like deductibles, coinsurance, and copayments.

Those that don’t have a Medigap plan will have to come up with the difference themselves. Here are some of the things you need to know to judge if you need a Medigap plan with your Original Medicare.

How Medigap Plan Can Help

Medigap plans are created to help fill the gap in the healthcare coverage that Original Medicare doesn’t cover. Medigap insurance plans take care of medical expenses such as deductibles, copayments, and coinsurance that a Medicare beneficiary is responsible for. In fact, more comprehensive Medigap plans pay for the medical services you receive outside of the United States.

There are ten standardized Medigap plans available in most states, and they are lettered: Medigap Plan A, B, C, D, F, G, K, L, M, and N. Each of the plan types offer a different level of benefits. Some plans cover coinsurance and copays, while some other plans cover Medicare deductibles either in parts or in full. For instance, Medicare Supplement Plan A is needed to be provided by any private insurer that sells Medicare Supplement policies and pays for items such as Original Medicare copayments and coinsurance in full. However, Plan A doesn’t cover Medicare deductibles.

Medicare Supplement Plan F is the most comprehensive option that can cover almost every deductible and copay you could face. However, it is important to note that Medicare Supplement Plan F has been phased out. But if you were eligible for Medicare before 2020, you can still get your Plan F coverage. However, if you don’t mind paying the Medicare Part B deductible in return for lower premiums, Medigap Plan G and N can be the right option.

Cost of Medigap

Each private insurance company set’s its own pricing for Medicare Supplement plans. Medicare Supplement plans are usually priced in one of three different ways, which include: Issue-age-rated, Community-rated, and Attained-age-rated. The cost of Medigap insurance plans can vary broadly.

The price of your Medicare Supplement premiums depends on several factors such as gender, age, location, tobacco use, and if the Medigap plan you select uses medical underwriting. 

Should I Get a Medigap Plan?

Whether or not you should purchase a Medicare Supplement depends on how much risk you are willing to take with your medical expenses. Original Medicare doesn’t cover everything and doesn’t have an out-of-pocket maximum. Several illnesses could potentially cost you a significant amount of money if the only health insurance plan you have is Original Medicare.

While purchasing a Medigap plan is an additional expense, it can help you define your medical expenses more accurately and provide you the peace of mind of knowing that unexpected medical expenses won’t ruin your credit due to unpaid bills.

For more information about the pros and cons of adding Medigap plans to your Original Medicare, contact Proinsurance Hawaii to determine your next steps.