Medicare Supplement Plans – How They Work

Medicare Supplement plans are plans that are designed to fill in the “gaps” in “original” Medicare. “Original” Medicare includes Medicare Part A (hospital inpatient) and Part B (outpatient/doctor). These plans are consistent across companies – all companies are required to provide the same standardized benefits. This makes it very easy to understand the plans and how they work. Here are the top three things that you must know when looking at Medicare Supplement plans:

1. Medicare Supplement plans (also called Medigap) are Federally-standardized. The plans all provide equal coverage for “like” plans. What this means is that a Plan F with one company is the exact same as a Plan F with another company. Because of this, it is important to compare the plans on the basis of monthly premium and company rating or reputation. Price being equal, it is preferable to be with a company that has a long track record of involvement in the senior insurance marketplace and/or a high financial strength rating.
2. Medigap plans can be used at any doctor or hospital, nationwide, regardless of which company sells you the plan. Many types of insurance are network-based; however, this does not apply to Medicare Supplement plans. Even some types of Medicare plans – Medicare Advantage plans – are network-based in most cases. On the contrary, Medigap plans give you the flexibility of using the plan anywhere in the country that takes Medicare. This flexibility, particularly for someone that travels, is one of the many reasons that these plans have become increasingly popular as a way to supplement Medicare coverage.
3. Medigap plans all pay claims through the Medicare “crossover” system. There is no variation in how quickly or how efficiently one company pays claims versus another. While some companies may use the selling point of their timeliness in paying claims, this is not altogether accurate when it comes to this type of insurance. Because the plans are Federally-standardized and pay claims this “crossover” system, you can be assured that, regardless of the company, the claims are going to be paid in a timely manner and with minimal (usually no) involvement from the insured. Once you have a plan, you just need to present your plan identification card with your red, white and blue Medicare card when receiving services from a doctor or hospital.

Altogether, Medicare Supplement plans continue to be a viable option for those on Medicare, who wish to limit their exposure to out of pocket expenses. With only Medicare, you are subjected to paying approximately 20{dc95c22c9cec96e4b887cb128e750bad45acd6bf2ff75ab29d9ade61e84bfb51} of all medical costs. With a Medigap plan, however, you can greatly reduce or, with some plans, completely eliminate your out of pocket costs.