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Medicare Supplements Explained

Medicare supplements are one way Medicare beneficiaries can get additional coverage to their benefits under Parts A and B of Original Medicare. A Medicare supplement, also called a Medigap plan, will act as your secondary insurance plan and pay for costs that remain after Parts A and B pay their share.

How Medicare Supplements Work

Medicare supplements are probably the easiest thing to learn about Medicare. There are a few features that apply to all supplements.

Standardization

You have about ten Medigap options to choose from, plus two high-deductible plan options. All of them are federally standardized, which means that no matter where you live or which insurance company offers the plan, it will always be the same. This is why it’s important to look at rates from different carriers. Why pay more for the same plan? Medigap plans never change their coverage or benefits.

Provider Acceptance

Another advantage of Medicare supplements is that they do not use provider networks. As long as your doctor accepts Medicare, they’ll also accept your Medicare supplement. Since more than 90% of providers accept Medicare, you’ll have no problems finding a provider you can see. You won’t be limited on which providers you can see. If you travel frequently or have homes in different parts of the country, you’ll be able to use your plan no matter where you are.

Claims Processing

The claims process for Medicare supplements is very simple. Your provider will file with Original Medicare first since it will be your primary insurance. Once they pay, they’ll send a copy of your claim to your Medicare supplement insurance company. There are far fewer rules surrounding your benefits in these plans, so claim denials are rare.

Guaranteed Renewable

Medicare supplements are also guaranteed renewable. No matter how much your plan spends on your medical bills or what healthcare conditions you have, your plan can never terminate your coverage. The only way to lose your Medigap plan is if you stop paying your monthly premiums.

Eligibility

All Medicare beneficiaries who are enrolled in Parts A and B can choose to enroll in a Medigap plan. If you do so during your Initial Enrollment Period (IEP), you will not have to go through medical underwriting. This is called “guaranteed issue rights.” It means that the insurance company cannot deny coverage based on your health status, nor can they charge higher premiums for a plan.

Outside of your IEP, you will usually have to answer health questions before being granted a Medicare supplement. Some states have more relaxed rules than others, so you’ll need to ask your Medicare advisor about your eligibility status.

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Medicare sure can be confusing, huh? We made a video that goes through Medicare step-by-step. This is the easiest way to learn. Check it out!