medigap plan, medicare

How Much Medigap Coverage Do I Need?

Medigap is a separate plan you can add to your Medicare policy. It provides extra coverage to minimize your out-of-pocket costs, with the possibility of some out-of-pocket expenses being eliminated altogether. There are 10 options to choose from, all with different coverage amounts. 

What do I need to know before joining?

There are certain conditions you must meet before you can get a Medigap plan. You have six months from the day you turn 65 and enroll in Medicare Parts A and B to join. Your insurance company may deny you the ability to get a Medigap policy after this period passes.

You also cannot have Medicare Advantage and Medigap at the same time. In fact, it is illegal for someone to try to sell you a Medicare Advantage policy while you’re enrolled in Medigap.

If you turned 65 on or after January 1, 2020, Plans C and F will not be available to you.

How does it work?

This is not a standalone insurance plan. It is a supplement to the Original Medicare policy you already have. For a Medicare Part A service, a Medigap plan can take care of the deductible and coinsurance so that you do not pay anything for inpatient treatment. 

For Medicare Part B, it approves an amount for your outpatient treatment, which it pays 80% of. That remaining 20% is left up to you – but Medigap can cover this.

What does Medigap cover?

Medigap plans consist of A, B, C, D, F, G, K, L, M, and N. Each covers varying amounts of out-of-pocket costs.

Here are costs that all plans cover (Plan K covers 50% and L covers 75% of costs aside from Part A hospital coinsurance):

  • Medicare Part A hospital coinsurance 
  • Part B coinsurance or copayment
  • First three pints of blood
  • Part A hospice coinsurance or copayment

Plans covering skilled nursing coinsurance:

  • All except for Plans A and B

Part A deductible:

Part B deductible:

  • C and F

Part B excess charge:

  • F and G

Foreign travel exchange (80% costs)

  • C, D, F, G, M, and N

Plans K and L are the only plans with out-of-pocket limits, which are $6,220 and $3,110, respectively.

What is the best one for me?

The amount of coverage you need depends on what your outlook is. If you’re conservative and want to be prepared for any out-of-pocket cost, Plans such as C, D, F, and G are ideal because they’re the most extensive. If you are in good health, then Plans A and B may be suitable because they cover the basics. For coverage that balances simplicity and extensiveness, Plans K, L, M, and N are effective. 

We can help you decide

At Turning 65 Solutions, we’re here with you every step of the way and will help you find a Medigap plan that works for you. To begin saving more, call us today at 830-217-6711.

Turning 65 Solutions can help you plan for the future.