What Does a Medicare Supplement Plan Cover?

Medigap plans help cover "gaps" in Original Medicare, such as:

• Copayments

• Coinsurance

• Deductibles

• Emergency foreign travel expenses (in some plans)

These plans are especially helpful for people who want more predictable out-of-pocket costs and fewer surprises when accessing medical care. Think of these plans as "All You Can Eat" because you pay once per month, and you can use all the benefits as many times as you want and not have to pay anything extra.  Although the three most popular plans are G, N, F (in that order), there are a wide variety of plans you can still purchase.

Key Features of Medicare Supplement Plans:

• Standardized Benefits: Plans are identified by letters (such as Plan G, Plan N, etc.) and have uniform benefits across most states, so a Plan G from one insurer provides the same core benefits as a Plan G from another company.

• Standardized Deductibles: Any plan with a deductible (Hospital A or Medical B) must match the deductible amounts set by CMS (Medicare). This means that if your plan includes a Part B deductible, it will be consistent across different providers.

• Freedom to Choose Providers: You can see any doctor or hospital in the U.S. that accepts Medicare without being restricted by networks. While providers can limit the number of Medicare patients they accept, they cannot refuse your Supplement Plan if they are still accepting new patients.

• No Referrals Needed: You can visit specialists directly without needing a referral, provided the specialist accepts Original Medicare.

• Works Only with Original Medicare: Enrollment in both Medicare Part A and Part B is required to buy a Medigap plan.

• Does Not Include Drug Coverage: Prescription drug coverage is not included; a separate Part D plan is necessary for medications and other optional supplemental plans.at To Watch Out For With Medicare Supplements

• Skilled Nursing Facility (SNF) May Not Be Covered:  You must have a 3-day in-patient Hospital stay before a SNF will be approved and paid for by Medicare and your Supplement Plan.  The day you're discharged does not count towards your 3-day requirement, neither do observation days.   Coverage ends after 100 continuous days in a SNF in which you are liable for all costs, this is also known as a "Benefit Period."  You can have multiple Benefit Periods throughout the year.

• Rates Increase Yearly:  As we age, we usually consume more health care, which costs the insurance company more money.  Rates will typically go up 5% ~ 20% per year.  Some years your company may skip a rate increase, then come back the next year with a very high increase. Past rate increases are no indication of what future increases will be.  No single company does this more than anyone else, they are all about the same in this regard.

• They Do Not Cover Part D Prescriptions: Medicare Supplements do not have a drug plan element to them, they are only there as a financial shield.  You must purchase a Medicare Prescription Drug Plan seperately, and failing to do so may result in late enrollment penalties.  They also do not cover Dental, Vision, Hearing.  To clarify, Medicare or your Supplement plan does not pay for:

Important Things To Keep An Eye Out For Supplements Plans:

Skilled Nursing Facility (SNF) Coverage Limitations: To qualify for Medicare and Supplement Plan coverage for a Skilled Nursing Facility stay, you must have a prior hospital inpatient stay lasting at least three days. The discharge day and observation days do not count toward this three-day requirement. Coverage for SNF care lasts up to 100 consecutive days per "Benefit Period," after which you are responsible for all expenses. You can have multiple Benefit Periods within a year.

Annual Rate Increases:
Insurance costs generally rise as people age due to increased healthcare usage. Medicare Supplement rates often increase annually by 5% to 20%. While some years might see no increase, following years could have significant hikes. Past increases do not predict future changes, and no single insurer consistently raises rates more than others.

Medicare Supplement Exclusions:
Medicare Supplement plans do not include prescription drug coverage (Part D). You must enroll in a separate Medicare Prescription Drug Plan to avoid penalties for late enrollment. Additionally, these plans do not cover dental, vision, or hearing services. Specifically, Medicare and Supplement plans do not cover:

• Dental care such as cleanings, X-rays, fillings, root canals, crowns, and similar procedures.

• Vision services including refraction tests, prescription glasses, or contact lenses.

• Hearing exams and hearing aids.