Medicare Supplement Insurance is a popular coverage that many people combine with their Original Medicare benefits. While there are many useful benefits that come with Medicare Supplement plans, it can be hard to know how they work and which ones are worth considering. To help you decide, we wrote this guide to Medicare Supplement plans in California.
Medicare Supplement Insurance is a secondary coverage that’s designed to work with your Original Medicare benefits. These plans supplement your Part A and Part B coverage by paying for amounts that Original Medicare doesn’t. The amounts that Medicare doesn’t cover are often called gaps. The gaps in Medicare include:
These charges don’t come with any kind of cap or limit under Original Medicare; you are not protected from runaway medical expenses in any way. Medicare Supplement plans solve that problem. They step in where Original Medicare leaves off. Because these plans fill in or close some of these gaps, they are very often called Medigap plans. When you see a provider, you’ll provide both your Medicare card, and your Medigap Plan card. Your provider will bill both:
If there’s still an amount due, you’ll be responsible for it. In this way, Medicare Supplement Insurance can greatly reduce the amount of money you have to pay for medical care when you have Medicare.
Medicare Supplement plans are standardized throughout 47 of the United States. Massachusetts, Minnesota, and Wisconsin have their own Medigap plans and laws. In the rest of this article, we’ll be talking about the way Medigap plans work in the 47 standardized states. There are 11 standardized Medigap plans currently available. They are each known by letter: Plans A, B, C, D, F, G, K, L, M, N, High Deductible F, and High Deductible G. Plans F, High Deductible F, and C are not available to anyone who becomes eligible for Medicare after December 31, 2019. Each one of the 11 standardized plans covers a different mixture of the costs and gaps in Part A and Part B. Some are more comprehensive, and others less so. This allows you to determine a level of coverage you think you need based on your needs.
Historically, Plan F has been the most popular Medicare Supplement plan. Since that plan isn’t available to new Medicare Beneficiaries, we’ll review the three most popular plans available today.
This is the most basic plan, with the lowest level of coverage. Because of this, it’s also generally the most affordable Medigap plan available. Plan A only covers these gaps in Original Medicare:
With Medigap Plan A, you’re on the hook for all of the other costs of your coverage, including the Part A deductible. Plan A doesn’t give you coverage outside the U.S.
Plan G is the “new” Plan F; it covers almost all of the gaps in Medicare. The only gap Plan G leaves open is the Part B deductible. You have to meet this deductible before the plan will help pay your Part B costs. Since the Part B deductible is only $233 for 2022, you’re limited to a very small out of pocket expense during the year. Plan G is the most comprehensive plan available to new Medicare Beneficiaries.
Plan N has coverage similar to Plan G, but with a few twists that make it a more affordable option. First of all, you’ll pay a $20 co-payment for office visits, and a $50 co-payment for Emergency Room visits. If you end up being admitted to the hospital after visiting the ER, your co-payment is waived. Besides this cost, Plan N also leaves you exposed to Part B excess charges. Excess charges are extra amounts that certain medical providers can add on to the normal cost for services and procedures. Excess charges are fairly rare, so they tend to not add much in the way of out of pocket expenses. Aside from these differences, the coverage between Plan N and Plan G are almost identical, but the cost for Plan N is usually quite a bit lower than for Plan G, giving it an attractive value.
Picking a Medigap plan comes down to deciding how much coverage you want, and then finding the best price available. You’ll want to consider your coverage needs:
By going over these questions, you can find out which Medigap plan will fit your needs. Once you’ve done that, you can shop for the best deal available.
In order to enroll in Medicare Supplement plans in California, you have to first be enrolled in both Part A and Part B of Original Medicare. You also have to stay enrolled in Part B by paying your Part B premium on an ongoing basis. Once you’re enrolled in Parts A and B, and you’ve chosen your Medigap plan, you can enroll in it in a number of ways:
If you’re working with a licensed health insurance agent, you can get help choosing and enrolling in the plan of your choice.
The best time to enroll in a Medigap plan is during your Medigap Open Enrollment Period. This enrollment window lasts for six months and starts when you have turned 65 and are also active in Medicare Part B.
Every Medicare Supplement plan with the same plan letter (F, G, etc) offers precisely the same benefits to you, but prices vary widely from one insurer to another. It’s in your best interest to have access to as many plans by as many insurers as possible when you make your Medicare Supplement plan.
That’s where Medicare Consumer comes in. When you speak with our experts you get access to plans from dozens of different insurers. They’ll guide you to the right plan for you at the best possible rate.
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