If you’re not totally sure about the difference between Medicare Advantage and Medicare Supplement, you can refresh your memory.
If you’re not sure what the best option is for you, you can take this short quiz to help nudge you in the right direction. Otherwise, let’s jump into it.
Let’s review the basics
In general, Original Medicare (Parts A & B) covers 80% of your out-of-pocket medical costs. A Medicare Supplement plan (also called a Medigap plan) supplements Original Medicare to fill in the 20% gap.
If you’re new to Medicare, you can enroll in a Medicare Supplement plan no questions asked. However, after that “guaranteed issue” period, you will likely have to go through medical underwriting — you can be denied or charged more based on your health. That’s why it’s so important to make the right choice the first time you’re eligible.
Keep in mind, you’ll need separate coverage for prescription drugs. In fact, you’ll be penalized if you go without prescription drug coverage. So we recommend you get a plan even if you aren’t currently taking any prescriptions. You’ll also need separate policies for dental, vision and/or hearing insurance.
The Standard is the standard
Medicare Supplement plans are standardized. What does that mean? Every Plan G offers the same coverage no matter which company offers it. A Humana Plan G and an Aetna Plan G and a UnitedHealthcare Plan G and a Mutual of Omaha Plan G are identical.
That means you can compare plans purely based on price. We recommend you narrow your selection down to a subset of Medicare Supplement plans, then compare across the lowest premium version of each plan.
Not all companies are required to offer all plans, and they typically do not offer all plans.
Why are there so many Medicare Supplement plans?
It’s hard to explain why there are so many Medicare Supplement plans, but I can try to help you understand the differences. We think it’s helpful to group plans into similar bundles.
The popular kid in town
For years, Medicare Supplement Plan F was the most popular plan. More than 50% of plans purchased were Plan F. However, Medicare beneficiaries who become eligible after January 1, 2020, will no longer be able to purchase Plan F. Plan F was popular because it covered all out-of-pocket expenses.
Plan G has recently taken over as the most popular plan. It covers all out-of-pocket expenses, except the Part B deductible, which is $198 in 2020.
This plan is particularly popular, because it reduces your medical expense volatility. It’s usually the highest premium plan (the amount you pay each month for the insurance), but at least you know what you’re going to pay.
The most you could pay in a year is your monthly premium multiplied by 12, plus $198. No matter how much treatment you receive, you will only pay that much.
Who is Plan G a good fit for?
If you can reasonably afford the premium for Plan G, it’s probably a good fit. Keep in mind, moving plans in the future can be very difficult, so it’s comforting to be in the plan with the most coverage. It’s important to consider what your needs might be in 20 to 30 years.
Shop Medicare Supplement Plan G
The next closest options
Medicare Supplement Plan N and Plan D offer nearly identical coverage to each other, and to Plan G. But Plan N and D do not cover Part B excess charges. Medicare Part B excess charges are the difference between how much a doctor charges for a treatment or procedure and how much Medicare has agreed to pay for it.
Learn more about Part B excess charges here.
Plan N has one minor difference: you’ll have a $20 co-payment for a doctor’s office visit, and a $50 co-payment for the emergency room.
Who is Plan N or Plan D a good fit for?
“If you are pretty healthy and don’t go to the doctor often, Plan N may be a more cost-effective option than Plan G,” says Medicare expert Danielle Roberts. “If you go to the doctor once a month, Plan G would likely be more cost-effective than Plan N.” If you travel abroad frequently, you might opt for a plan that covers emergency services in other countries.
Shop Medicare Supplement Plan N and D
Your high-deductible options
You’re probably familiar with high-deductible insurance plans, as they’ve become rather popular parts of employer coverage.
Reminder: the deductible is the amount you pay before your insurance coverage kicks in. These plans have a much lower premium (the amount you pay each month for the insurance) than a traditional insurance policy. That’s the trade-off you’re making.
There is a Medicare Supplement Plan G High Deductible. It offers the same coverage as a standard Plan G, after you reach the $2,340 deductible. [Note: For beneficiaries eligible before January 1, 2020, there is also a Plan F High Deductible. That is going away, and is no different than Plan G High Deductible, because of the unique features of high-deductible plans.]
With a Medicare Supplement insurance plan, you still have your Original Medicare coverage. That means only your out-of-pocket cost sharing expenses after Original Medicare count against your Medicare Supplement deductible. This is a pretty confusing concept, so let’s look at an example.
Assume you have a medical bill for $10,000.
Original Medicare generally covers 80% of your costs, so it will pick up $8,000.
You are responsible for $2,000.
This $2,000 counts against your Medicare Supplement deductible.
Once you’ve reach the $2,340 deductible, your High Deductible Plan G will pick up the remaining costs.
For the rest of the year, your High Deductible Plan G will cover your costs.
Who is High Deductible Plan G a good fit for?
People who are generally pretty healthy, want the flexibility of a Medicare Supplement plan, want to save on premiums and want complete protection if they have a very unhealthy year.
Shop high deductible Medicare Supplement plans
Although they’re not traditionally very popular, Medicare Supplement Plan K and Plan L offer unique features that should be considered. Plan K and Plan L are similar to Plan N, but they only cover some of your out-of-pocket expenses.
Plan L and Plan K have out-of-pocket limits to cap your potential medical costs. Similar to a high-deductible plan, in exchange for sharing expenses along the way, your premium (the amount you pay each month for the insurance) will be lower.
Who is Plan K or Plan L a good fit for?
Appetite for these plans comes down to personal preference. If what I just describe sounds like an attractive option, check out available options for Plan K and Plan L.