Understanding Medicare Supplement Insurance (2024)

FAQs

What is the downside to Medicare Supplement plans? ›

The downside of high-deductible Plan G can, of course, be your upfront cost before you receive help with out-of-pocket expenses. Assuming you have this high-deductible Medigap plan and receive a Medicare Part B-covered service, you'll be responsible for the Part B deductible, which is $240 in 2024.

Supplemental insurance is advisable for those with Medicare to help cover out-of-pocket costs and gaps in coverage, offering financial protection for deductibles, coinsurance, and other medical expenses not fully covered by Medicare.

By and large, Plan F is the most popular Medicare Supplement plan due to its coverage of more out-of-pocket Medicare costs than any other Medigap plan type.

With Medicare Supplement Plan F, you get the most complete coverage available. And because Plan F also covers costs in excess of Medicare-approved amounts, you may have no out-of-pocket costs for hospital and doctor's office care.

As is true for all supplemental policies, these plans are not adequate as stand-alone health coverage, as they can leave you with unlimited out-of-pocket costs in the event of a serious medical condition.

Medicare Supplement plans, also known as “Medigap,” help pay your share of medical costs not paid by Original Medicare, like copayments, coinsurance and deductibles. Some Medigap plans may also assist in paying for home healthcare , durable medical equipment (DME) , hospital costs and lab costs.

The biggest difference between Medigap and Medicare Advantage is that with a Medigap plan, you have the freedom to see any doctor that accepts Medicare, whereas with Medicare Advantage, you must get care within the plan's network of doctors and hospitals unless it's an urgent or emergency situation.

Fortunately, Medicare supplemental insurance may be worth the extra cost. It can be worth it if you have leftover bills unpaid by your health insurance and Medicare plans.

Plan G does not cover the Part B deductible or any service that Medicare does not cover. For example, Medicare does not cover routine dental, vision, or hearing; therefore, Plan G won't cover those services. Medicare pays first, and then Plan G pays the remaining amount after you pay the once-annual deductible.

Is the medicare plan G worth it? ›

Plan G is more expensive than some other Medigap plans, costing an average of $148 per month. But the extra cost can be worth it since Plan G will pay for nearly all of your medical costs, except your Part B deductible. What is Medicare Plan G?

In 2021, Medicare Advantage covered nearly half of all Medicare beneficiaries (47%), or 27.6 million people with Medicare. (The number and share of Medicare Advantage enrollees has increased since 2021, up to 30.8 million in 2023, or 51% of all eligible beneficiaries.)

Because Medigap Plan F offers the most benefits, it is usually the most expensive of the Medicare Supplement insurance plans.

In return for a higher monthly premium up front, Plan F covers the Medicare Part B deductible AND the remaining 80% of costs that Original Medicare doesn't cover. This type of coverage, also known as “first dollar coverage,” means that you have no expenses for covered medical services beyond your monthly premium.

Is a Medicare Supplement plan better than an Advantage plan? Medigap and Medicare Advantage plans offer different benefits, and which will better serve you depends on your specific health needs. Medigap plans offer additional coverage for people enrolled in Original Medicare, but they exclude prescription drugs.

Restrictive networks

Medicare Advantage plans, however, have provider networks. In some cases, you'll have a higher share of costs when you see an out-of-network doctor. In other cases, you're not covered at all if you go out of network.

Most individuals that dislike a Medicare Advantage plan usually have had a bad experience with in-network providers, plan authorizations for medical care, or having to wait a long time to have an appointment scheduled. Some of these concerns can be attributed to the healthcare provider.