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The ABCs of Picking a Medicare Supplemental Policy

Posted: 3/9/2017 7:21 AM by Interim HealthCare

Dear Savvy Senior,
Can you provide any advice on choosing a Medicare supplemental policy to help cover things outside of Medicare? I’ll be 65 in a few months and could use some assistance.
Looking for Help

Dear Looking,
If you plan to enroll in original Medicare, getting a supplemental policy (also known as Medigap insurance) too is a smart idea because it will help pay for things that aren’t covered by Medicare like copayments, coinsurance and deductibles. Here are some tips to help you choose an appropriate plan.

Medigap Plans
In all but three states (Massachusetts, Minnesota, and Wisconsin), Medigap plans, which are sold by private health insurers, come in 10 standardized benefit packages labeled with the letters A, B, C, D, F, G, K, L, M and N.

Plan F is the most popular policy followed by plan C because they provide comprehensive coverage. Plans K and L are high-deductible policies that have lower premiums but impose higher out-of-pocket costs. Plan F also offers a high-deductible version in some states. And a popular middle ground policy that attracts many healthy beneficiaries is plan N.

For more information on the different types of plans and the coverage they provide, including Medigap options in Massachusetts, Minnesota, and Wisconsin, see Medicare’s “Choosing a Medigap Policy” guide at Medicare.gov/pubs/pdf/02110-medicare-medigap.guide.pdf, or call 1-800-MEDICARE and ask them to mail you a copy.

How to Choose
To pick a Medigap policy that works best for you, consider your health, family medical history and your budget. The differences among plans can be small and rather confusing.

To help you choose, visit Medicare.gov, and click on “Supplements & Other Insurance” at the top of the page, then on “Find a Medigap policy” and type in your ZIP code. This will give you a list of the plans available in your area, their price ranges and the names, and contact information of companies that sell them. But it’s up to you to contact the carriers directly to get there specific pricing information.

You can also compare Medigap prices on most state insurance department websites (see NAIC.org/state_web_map.htm for links), or you can order a personalized report from Weiss Ratings for $99 at WeissMedigap.com.

Since all Medigap policies with the same letter must cover the exact same benefits (it’s required by law), you should shop for the cheapest policy.

You’ll get the best price if you sign up within six months after enrolling in Medicare Part B. During this open-enrollment period, an insurer cannot refuse to sell you a policy or charge you more because of your health.

You also need to be aware of the pricing methods, which will affect your costs. Medigap policies are usually sold as either: “community-rated” where everyone in an area is charged the same premium regardless of age; “issue-age-rated” that is based on your age when you buy the policy, but will only increase due to inflation, not age; and “attained-age-rated,” that starts premiums low but increases as you age. Community-rate and issue-age-rated policies are the best options because they will save you money in the long run.

You can buy the plan directly from an insurance company, or you can work with a reputable local insurance broker.

Drug Coverage
You also need to know that Medigap policies do not cover prescription drugs, so if you don’t have drug coverage, you need to consider buying a separate Medicare Part D drug plan too. See Medicare.gov/find-a-plan to compare plans. Also note that Medigap plans do not cover vision, dental care, hearing aids or long-term care either.

Alternative Option
Instead of getting original Medicare, plus a Medigap policy and a separate Part D drug plan, you could sign up for a Medicare Advantage plan that provides all-in-one coverage. These plans, which are sold by insurance companies, are generally available through HMOs and PPOs. To find and compare Advantage plans visit Medicare.gov/find-a-plan.