If you’re approaching age 65, or you already happen to be on Medicare, you may have heard of the term “Medicare Supplement Plan”, a.k.a. “Medigap”. These specific plans assist in covering out-of-pocket costs which original Medicare (Parts A & B) does not cover. The question is: how do Medicare Supplement Plans work, and are they the correct choice for your needs? Here at The Lambert Agency, we specialize in breaking down Medicare coverage in simple, easy to understand terms. In this guide, we’ll go over all of the essential elements of Medicare Supplement Plans and provide our guidance every step of the way. Enjoy!
Addressing the Gaps in Original Medicare
Original Medicare is certainly a strong foundation for accessible healthcare during retirement years, yet it may leave you responsible for the following deductibles:
- Part A hospital deductibles
- Part B annual deductibles
- Copayments for any and all doctor visits and hospital stays
- Coinsurance (which is your share of the costs for covered services)
- No out-of-pocket maximum
Simply put, this means a single illness or extended hospital stay could possibly lead to significant out-of-pocket expenses. Thankfully, this is where a Medicare Supplement Plan comes in to help.
What Is a Medicare Supplement (Medigap) Plan?
A Medicare Supplement Plan is simply a form of private insurance thoughtfully designed to “fill in the gaps” Original Medicare leaves behind. Through working alongside Parts A and B, some or all of the costs which Medicare does not cover are covered. When you choose to enroll in a Medigap plan from The Lambert Agency, you’ll be able to enjoy the following benefits:
- Predictable Costs: Many forms of copays, coinsurance, and deductibles will be covered
- Freedom of Choice: You’re able to see any doctor or hospital nationwide which accepts Medicare
- No Network Restrictions: Unlike Medicare Advantage plans, you are not tied to HMO or PPO network restrictions
- Guaranteed Renewable Coverage: As long as you successfully pay your monthly or annual premium, your plan cannot be cancelled
How Does a Medicare Supplement Plan Work?
Let’s break down a simple example of how a Medicare Supplement Plan works:
•You visit your doctor: Medicare Part B is able to pay 80% of the approved cost
•Without Medigap: You’d likely pay the remaining 20% out-of-pocket
•With a Medicare Supplement Plan: Your insurer (through us at The Lambert Agency) pays said 20% on your behalf.
All of this yields fewer surprises and even more predictable healthcare spending over time, helping you better manage your finances throughout the year
Popular Medicare Supplement Plans
While Medicare Supplement plans may vary, some of the most popular options for new Medicare Supplement Plan enrollees today consist of the following:
- Plan G: This is the most comprehensive plan available for those eligible after 2020 (it covers nearly everything except the Part B deductible)
- Plan N: Offers lower premiums in exchange for modest copays at your physician’s office or emergency room
- Plan F: This plan is only available if you were eligible for Medicare prior to January 1, 2020, yet it remains one of the most comprehensive plans overall
When you work with The Lambert Agency, we assist you in comparing these options side-by-side and help you decide which one is ultimately best for your overall budget and healthcare needs.
When Can You Enroll in a Medigap Plan?
Your Medigap Open Enrollment Period is the best time to sign up for a Medigap Plan. To enroll within this six-month window, you must be:
- 65+ years of age
- Enrolled in Medicare Part B
During this timeframe, you can purchase any and all Medicare Supplement plans with guaranteed acceptance (i.e.: meaning no medical underwriting or health questions). Once you’re outside of this window of time, you may end up facing restrictions or even higher than average premiums. For these reasons, it’s important to work with an agency such as The Lambert Agency to ensure everything is timed correctly and on the right track.
FAQs About Medicare Supplement Plans
Do Medigap plans include prescription drug coverage?
No. You’ll require a separate Part D plan for medications.
Are premiums the same everywhere?
No. Premiums may vary by carrier, location, and age. When you choose to work with The Lambert Agency, we’re able to shop around multiple carriers to locate the best rates for you and your unique scenario.
Can I use my Medigap plan outside the U.S.?
Some plans, such as Plan G and Plan N, include limited foreign travel emergency coverage.
Contact The Lambert Agency Today
A Medicare Supplement Plan is a very powerful way to protect yourself from any unexpected medical bills and gain an enhanced peace of mind during your retirement years. When you have predictable costs paired with nationwide provider freedom, it’s one of the best choices you can make as a 65+ senior citizen. When you contact The Lambert Agency, we go the extra mile to help you compare various options, enroll during the right window of time, and ensure your plan best fits your long-term healthcare needs. Feel free to contact us using the form below and we’ll be happy to help you every step of the way. We look forward to working with you soon!