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Is Medigap Right For You?

Medicare Supplement (Medigap) plans are one of the best ways to get coverage for your out-of-pocket costs. But is it right for you? Let’s find out.

What is Medigap?

There are ten different Medigap plans—A, B, C, D, F, G, K, L, M, and N, each with its own coverage. However, they all cover the same types of things, i.e., your Medicare out-of-pocket costs.

You can purchase one of these Medigap policies, and it will work alongside your Original Medicare (Part A and Part B) coverage. It will have a separate monthly premium, but that will be determined by the type of plan you purchase and other factors.

All plans cover some amount of these benefits:

  • Part A coinsurance and hospital costs
  • Part B coinsurance/copayment
  • First 3 pints of blood for transfusion
  • Part A hospice care coinsurance/copayment
  • Skilled nursing facility care coinsurance
  • Part A deductible
  • Part B deductible
  • Part B excess charges
  • Foreign travel care

Plan A offers the least amount of coverage, covering the first four items on this list, but it has the lowest monthly cost. Plan F offers the most coverage, covering all of these items at the highest cost. However, Plans C and F are no longer available to Medicare enrollees who became eligible for Medicare after January 1, 2020.

Other plans have “quirks” to them for a more personalized option. Plan K, for example, covers 50% of some of the costs and also has an out-of-pocket limit to reduce your costs.

How it Compares

With an understanding of how Medigap works, we can see how it compares to other Medicare coverage options. A common alternative to a supplement is Medicare Part C or Medicare Advantage.

A Medicare Advantage plan will provide benefits within a network of select providers in your area. With a Medicare Advantage Health Maintenance Organization (HMO) plan, you will have primary care doctors and a small network at a low monthly cost, sometimes even $0. On the other hand, Preferred Provider Organization (PPO) plans offer a larger network without a primary care doctor, and you can even go outside of the network to receive care, but at a higher cost. You can also get Part D prescription drug coverage through an Advantage plan, which you can’t get with Medigap—a deciding factor for many individuals.

In summary, Medigap covers costs associated with Original Medicare, while Medicare Advantage covers healthcare costs directly.

No More Medicare Frustration—Call Peritia Advisors

We will help you push past frustration and into your best Medicare coverage. To learn more, call Peritia Advisors at 319-200-5050.