What is the most shocking aspect about Original Medicare? The majority of participants said it’s the unpredictability of out-of-pocket expenses. Medicare deductibles, coinsurance, and copayments may wreak havoc on even the most meticulously prepared budget. As a result, more than 40% of persons enrolled in Original Medicare purchase a Medicare Supplement plan. When selecting Medigap coverage, keep in mind that it is not a one-size-fits-all answer for coverage. Medicare has approved ten different Medicare Supplement plans, each with a different amount of benefits. The three most prevalent plans are Plan F, Plan G, and Plan N. (accounting for over 80 per cent of all plans sold).
What Are the Benefits of Medicare Supplement Plans?
The following are the core benefits provided by all ten Medicare Supplement plans:
- Your Part A Coinsurance will be paid in full. After your Part A benefits have been spent, you have an additional 365 days of coverage.
- Coinsurance (Part B) Plan K pays 50%, Plan L pays 75%, and the rest of the plans pay 100%.
- Three Pints of Blood in the Beginning Plan K pays 50% each year, Plan L pays 75%, and the rest of the plans pay 100%.
- Coinsurance for Hospice Part A All other plans pay 100%. Plan K pays 50%, Plan L pays 75%, and all other plans pay 100%.
Some plans go beyond these basic benefits to cover things like your Part A and Part B deductibles, Part A skilled nursing facility coinsurance, and Part B excess charges, among other things. A few plans also include a foreign travel emergency benefit, which helps cover medical costs if you require treatment while travelling outside of the US.
What Is the Appeal of Medicare Supplement Plan F?
You pay nothing out of pocket for Medicare-covered services if you choose Plan F. Plan F covers your Part A as well as Part B deductibles, coinsurance, and excess costs in full. Plan F is also a good option if you’re anxious about budgeting for healthcare bills because you’ll know exactly how much you’ll spend each month on Medicare expenses.
What is the cost of Medicare Supplement Plan F?
Plan F has the highest premiums of any Medicare Supplement plan. This makes sense because it provides the most comprehensive coverage. The cost of a Medicare Supplement depends on several criteria, including your age, gender, smoking status, and ZIP code. Plan F has a lower monthly premium because it has a higher deductible. A high-deductible version of Plan F is also available. The high-deductible plan requires you to pay the first $2,340 in out-of-pocket expenditures (in 2020), after which your plan will cover 100 per cent of your share of approved Medicare services.
You would pay the $1,484 Part A deductible, the $203 Part B deductible, and the first $742 of your Part A and Part B coinsurance if you went to the emergency room for chest pain and were admitted to the hospital for a week. For the rest of the calendar year, your plan would cover 100 per cent of the remaining charges for that admission and all other services. In 2020, the average monthly premium for high-deductible Plan F will be roughly $50.
Is Plan F on its way out?
Plan F is no longer an option to those who become eligible for Medicare on or after January 1, 2020, thanks to legislation passed in 2015. The good news is that you may still be able to purchase Plan F if you were first eligible before that date.
Excess Charges for Plans F and B
State-specific laws apply to Medigap policies in some states. Currently, eight states prohibit providers from charging the 15% Part B excess charges. If you live in one of the following states, buying a plan without the Part B excess charges benefit could save you money.
- New York
- Rhode Island
The Medicare Supplement Plan F is best for the following people:
- Before January 1, 2020, people who became eligible for Medicare for the first time.
- People who do not wish to pay any out-of-pocket expenses for covered medical services
- Those who visit providers who refuse to accept assignments and are invoiced for excess Part B charges
What Is the Appeal of Medicare Supplement Plan G?
Plan G provides nearly identical coverage to Plan F. The exception is that it does not cover the Part B deductible. Once you’ve met your Part B deductible, Plan G pays 100 per cent of your out-of-pocket payments for approved services.
How much does Plan G set you back?
The graph below displays the average 2020 Plan G premiums by enrollee age:
If you want the same comprehensive coverage with a reduced monthly price. There’s also a high-deductible Plan G option. Once you’ve spent $2,340 on covered healthcare, your plan will cover all of your out-of-pocket expenses.
Excess Charges for Plan G and Part B
Your Part B excess expenses are covered under Plan G. Plan D may be a viable option if you live in Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, or Vermont. This is because Plan D offers identical advantages as Plan G, except coverage for Part B excess payments. Comparing premiums to determine if you can save money with Plan D is a smart idea. The Medicare Supplement Plan G is best for the following people:
- People who wish to know what their out-of-pocket expenses will be.
- People who want the premium flexibility of a high-deductible plan but don’t want to pay as much.
What Is the Appeal of Medicare Supplement Plan N?
Plan N is a low-cost plan with a wide range of advantages. Except for the Part B deductible and excess charges, it covers 100 per cent of your out-of-pocket payments under Part A and Part B. The only catch with Plan N is that each time you see a doctor, you must pay a small copayment. The following is how it works: Assume you’ve already satisfied your annual Part B deductible. You pay a copayment of up to $20 at the doctor’s office, and your Medicare Supplement coverage covers the rest.
How much does Plan N set you back?
Plan N has an average monthly premium of $111. Copayments for routine and specialist treatment are usually up to $20, with emergency hospital visits costing up to $50. Copayments are usually not required for the following services:
- Visits to urgent care facilities
- Healthcare at home
- Long-lasting medical equipment
The Medicare Supplement Plan N is best for the following people:
- People looking for complete coverage at a modest monthly rate
- Those who don’t mind paying a minor fee at the time of service
- People who are not subject to Part B excess charges
Plan F, Plan G, and Plan N are the most popular Medicare plans because they guarantee predictable out-of-pocket expenditures. You know how much you’ll pay for healthcare regardless of which of these plans you choose. When comparing Medicare plans in your area, the Medicare Plan Finder is an excellent resource. If you want additional information about individual insurance companies and plan premiums, you can also speak with a qualified Medicare broker.