Medicare Supplement Plans - Overview
Information on Medicare Supplement Insurance
Medicare Supplement Plans, also known as Medigap Plans, are insurance policies that help cover some or all of the deductible, coinsurance, copay, and excess charge gaps that are not covered by Medicare, and are available to anyone enrolled in part A and B of Medicare.
Medicare supplements are somewhat unique in that, although this is insurance, Medicare has mandated a level of standardization that makes it easier to shop for Medicare supplements. As an example, many people aren't familiar with the fact that a Medicare Supplement Plan F from one company can be priced at $200/month while the same exact plan and coverage from another company can be around $100/month. No difference in benefit. No difference in physician's networks. The exact same Medicare supplement coverage! That bit of understanding can save someone $100/month or almost $1,200/year. We can ensure you find the Medicare supplement plan that's going to save you the most money. Get your Medicare Supplement Insurance quote online with us today!
Guaranteed Acceptance
Additionally, if you are just turning 65, you are guaranteed acceptance in any medicare supplement plan from any carrier as long as you enroll in a plan within six months after you turn age 65. All you have to do is make sure you are enrolled in Medicare Part A and Medicare Part B, pick and plan, and submit your application.
What Medicare Doesn't Cover
Medicare does not cover all health care costs. Medicare coverage consists of Part A (which covers hospital and skilled nursing facility care), and Part B (which covers doctor bills and other medical expenses).
Even with Medicare Part A and Part B coverage, you're responsible for some out-of-pocket expenses including:
- Part A hospital deductible ($1,156)
- Part B deductible ($140)
- Copayments for hospital stays over 60 days
- Care in a skilled nursing facility after 20 days
- 20% coinsurance for doctor bills and other medical expenses
Medicare Supplement Plans are Standardized
By law, Medicare Supplement insurance is standardized into twelve plans (Plans A through N). That means Plan F from one company must include the same benefits as plan F from another company. Since Medicare Supplement insurance plans are standardized and all insurance companies offer the same basic supplemental coverage, your Medicare supplement choice comes down to price and a company's service, reputation and experience with Medicare supplement insurance policies.
In addition to the standard Plan A-L Medicare supplement health care policies, Medicare SELECT is a type of Medicare Supplement health care policy that can cost less than standard Medicare supplemental. However, you can only go to certain doctors and hospitals for your care. In Illinois, Medicare Select plans are offered by BlueCross Blue Shield of Illinois.
Illinois - Most Popular Medicare Supplement Companies
BCBSIL - Most Popular Illinois Medicare Supplement Plans
Blue Cross and Blue Shield of Illinois offers the most popular Medicare Supplement plans in Illinois with the most competitive rates. For additional information on these plans:
Mutual of Omaha - Lowest Cost Illinois Medicare Supplement Plans
Mutual of Omaha Medicare Supplement Plans are highly popular in Illinois and usually have the lowest rates. They take an attained-age rating approach to pricing their Medicare supplements and have lower rates for non-tobacco users.
Eligibility
To qualify for a Medicare Supplement policy, you must be age 65 or older (may vary by state), enrolled in Medicare parts A and B, and you must reside in the state in which you are applying for supplemental coverage.
When to Enroll
Your open enrollment period is the best time to buy a Medicare Supplement policy because companies must sell you any plan they offer regardless of your pre-existing health conditions. Your open enrollment period lasts for 6 months and begins on the first day of the month in which you are age 65 or older and enrolled in Part A and B of Medicare.
An insurer must offer you any plan it sells and cannot charge more because of present or past health conditions during open enrollment.
Late Enrollment
To help control rising costs, carriers apply the pre-existing condition clause to newly issued Medicare Supplement plans in most states if you enroll after the open enrollment period. Expenses resulting from a condition existing six months prior to the supplemental policy effective date are not covered unless they are incurred three months after the supplemental policy effective date.
If the supplemental policy replaces another creditable individual or group insurance coverage due to a person's eligibility for Medicare, this Pre-Existing Conditions Limitation will be reduced by the number of months that coverage was in force. If this supplemental policy replaces another Medicare Supplement policy, this Pre-Existing Conditions Limitation will be reduced by the number of months that the coverage was in force.
Medicare Supplement Basic Benefits
Basic benefits included in all plans include:
- Hospitalization - Part A coinsurance plus coverage for 365 additional days after Medicare benefits end.
- Medical Expenses - Part B coinsurance (generally 20% of Medicare-approved expenses), or in the case of hospital outpatient department services under a prospective payment system, applicable copayments.
- Blood - First three pints of blood each year.
Medicare Supplement Benefits by Plan
The chart below shows the standard benefits included in each plan.
| Plans |
A | B | C | D | F* | G | K** | L** | N |
| Basic Benefits | X | X | X | X | X | X | 50% | 75% | X |
| Skilled Nursing Coinsurance | - | - | X | X | X | X | 50% | 75% | X |
| Part A Deductible | - | - | X | X | X | X | 50% | 75% | X |
| Part B Deductible | - | - | - | - | X | - | - | - | - |
| Part B Excess | - | - | - | - | 100% | 100% | - | - | 100% |
| Foreign Travel Emergency | - | - | X | X | X | X | - | - | X |
| At Home Recovery | - | - | - | - | - | - | - | - | - |
| Preventive Care | - | - | - | - | - | - | - | - | - |
*Plan F also has a high deductible option, which some companies may offer. These high deductible plans pay the same benefits as Plan F after one has paid a calendar year $2,070 deductible. Benefits from high deductible Plans F will not begin until out-of-pocket expenses exceed $2,070.
**Plan K and Plan L provide for different cost-sharing than plans A-F. Once you reach the annual limit, the plan pays 100% of the Medicare copayments, coinsurance and deductibles for the rest of the calendar year. The out-of-pocket annual limit does NOT include charges from your provider that exceed Medicare-approved amounts, called "excess charges." You will be responsible for paying excess charges.
2011 Medicare Supplement Changes
Medicare supplement (or Medigap) is private insurance that covers the "gap" between Original Medicare (Parts A and B) and what you pay out of your own pocket, such as deductibles, coinsurance and copayments. Medigap plan options were once as vast as health benefits plans, differing from health insurer to health insurer. In the early 1990s, the government standardized Medigap plans and allowed only ten plan designs to be sold. Those ten plans were each assigned a letter (A through J) so you could easily identify them from one private insurer to another. Those ten later grew to twelve as K and L were added to the plan design options.
It's important to understand what has changed with your Medicare supplement in 2011. If you haven't enrolled yet in a Medigap plan, be sure to read the latest information.
In 2011, the biggest Medigap change of note is that the plan design options are reduced back to ten, with four plans (E, H, I and J) eliminated and two new plans (M and N) added. If you already have one of the Medigap plans that are no longer available, you may keep it. Only two Medicare supplement in 2011 (Plan K and L) remain unchanged.
Core benefits
All plan designs continue to provide the same core benefits for Medigap in 2012, although some plans cover them differently. Core benefits include:
- Hospital coinsurances up to an additional 365 days over what Medicare Part A normally covers
- Medicare Part B copays and coinsurance
- Up to the first 3 pints of blood
- Part A hospice care coinsurance or copayments (This benefit was added to all plan designs effective June 1, 2010.)
- Preventive care coinsurance
Other benefits
These other Medigap benefits are mixed; some are covered and some are not, depending on the plan design you choose:
- Skilled nursing facility coinsurance
- Inpatient hospital deductible
- Medical deductible
- The amount that a health care provider may charge you over the Medicare allowed amount (also called Medicare Part B excess charges)
- At-home recovery (This former benefit is no longer covered by Medigap in 2011.)
- Foreign travel emergency
- Up to $120 preventive care. (This former benefit is no longer covered by Medigap in 2011 as Medicare now covers many of these services.)
Medigap supplemental changes for each plan design
Here is an outline of Medigap changes in 2011 by plan design. These Medigap changes took effect with plans effective June 1, 2010.
Plan A: Added the core benefit for hospice care copayment and coinsurance
Plan B: Added the core benefit for hospice care copayment and coinsurance
Plan C: Added the core benefit for hospice care copayment and coinsurance
Plan D: Added the core benefit for hospice care copayment and coinsurance
Plan E: This plan design was eliminated. If already enrolled before June 1, 2010, you may keep the plan.
Plan F: Added the core benefit for hospice care copayment and coinsurance. This plan offers all available Medigap benefits. It also offers a high-deductible version where you pay the first $2,070 of the deductible before the Medigap plan begins to pay.
Plan G: Added the core benefit for hospice care copayment and coinsurance. One significant difference to this Medicare supplement in 2011 is that it now covers 100% of Medicare Part B excess charges where, in the past, it only covered 80%. The only Medigap benefit that this plan design does not include is Medicare Part B deductible.
Plan H: This plan design was eliminated. If already enrolled before June 1, 2010, you may keep the plan.
Plan I: This plan design was eliminated. If already enrolled before June 1, 2010, you may keep the plan.
Plan J: This plan design was eliminated. If already enrolled before June 1, 2010, you may keep the plan.
Plan K: There is no change to this Medicare supplement in 2011. Plan K already covered, and still does cover, 50% of hospice care coinsurance and copayments.
Plan L: There is no change to this Medicare supplement in 2011. Plan L already covered, and still does cover, 75% of hospice care coinsurance and copayments.
Plan M: This is a new Medicare supplement plan design available as of June 1, 2010. It offers all core benefits listed above, plus it covers skilled nursing facility coinsurance, 50% of Medical Part A deductible, foreign travel emergency and preventive care coinsurance.
Plan N: This is a new Medigap plan design available as of June 1, 2010. This is similar to Plan M, except that it covers 100% of the Medicare Part A deductible. It also covers 100% of the Medicare Part B coinsurance, except up to $20 of the copayment for office visits and up to $50 for emergency room visits.