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Medicare doesn’t cover all of your health care expenses when you turn 65. Medicare Part A covers 80% of inpatient care in hospitals and skilled nursing facilities, and Medicare Part B covers 80% of outpatient care and medically necessary supplies. For the 20% not covered by Medicare, you have the option to purchase Medicare Supplement (Medigap) insurance from a private insurance company.To determine the best Medicare Supplement providers, the orbes Health editorial team analyzed data on U.S. insurance companies that offer plans nationwide by the number of states in which they provide coverage, the number of types of plans they offer, how they rank in terms of their financial health by agencies like A.M. Best and more. Read on to see which providers made our list.
To determine the best Medicare Supplement providers for 2024, the Forbes Health editorial team evaluated all insurance companies that offer plans nationwide in terms of:
We focused exclusively on providing general summaries of the companies and their reputations. In order to provide specific plan recommendations accurately, it’s important to take into account the ZIP code and demographic details of the individual seeking insurance coverage. To do so, we recommend using Medicare.gov’s plan finder tool or seeking the expertise of an independent, agnostic insurance agent.
Medicare Supplement, also known as Medigap, is a private insurance policy purchased to help pay for what isn’t covered by Original Medicare (which includes Part A and Part B). These secondary coverage plans only apply with Original Medicare—not other private insurance policies, standalone Medicare plans or Medicare Advantage plans.
Medigap plans generally don’t cover prescriptions, so you may want to consider enrolling in Medicare Part D, which specifically covers prescription drugs, or a Medicare Advantage plan that includes drug coverage.
Medigap plans aren’t the same as Medicare Part C, also known as Medicare Advantage. While a Medicare Advantage plan can serve as an alternative way to get Medicare Part A and Part B coverage, Medigap plans only cover what Part A and Part B do not.
Medigap supplement plans cover many out-of-pocket costs that may come with Original Medicare but aren’t covered by Part A or B, including:
Additionally, some Medigap plans may also cover emergency medical services when traveling outside of the U.S.
To be eligible for a Medicare Supplement plan, you must be enrolled in Original Medicare Part A and Part B, but not a Medicare Advantage plan. You must also be in one of the following categories:
Companies could delay coverage up to six months for a pre-existing condition if you didn’t have creditable coverage (other health insurance) before enrolling in Medicare.
Your Medicare Supplement open enrollment period starts the first month you sign up for Medicare Part B insurance at age 65 or older, even if you delayed enrollment because you had group health coverage. Medigap policies cannot be canceled by the insurance company even if your health status changes as long as you pay your premiums. If you’re already enrolled in a Medigap plan, you may apply to buy or switch plans.
“Medicare supplements vary in rate by carrier and plan choice. Not every carrier offers all plans,” says Brandy Corujo, partner of Cornerstone Insurance Group in Seattle. Policy prices for Medigap are set by the individual insurance companies selling them. Companies set their premium pricing in one of three ways:
Some factors that may also influence your rates include your location, gender, marital status and lifestyle (like if you smoke).
Medigap plans are purchased through a private insurance company, and you pay a monthly premium for the policy directly to the company. Medigap policies can be purchased from any insurance company licensed to sell one in your state, but available policies and prices will depend on your state. Medigap plans only cover one person, so married couples need to purchase separate policies.
The cost of Medigap monthly premiums varies depending on factors like the insurance company’s pricing policies and an individual’s age, sex and personal health history.
For example, a person living in North Carolina might expect to pay the following prices for various Medigap plans, based on their location:
Keep in mind, Medicare Supplement plans C, F, and F high deductible are no longer available to purchase if you turned 65 on or after January 1, 2020. They may be unavailable to some people under age 65 as well.
Medicare Supplement plans F, G and N are the most popular Medigap plans with the highest rates of enrollment nationwide. Which one is best depends on the beneficiary and their specific health care needs.
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. Plan F pays for Medicare deductibles, copays and other costs associated with Medicare-covered services, so beneficiaries don’t have to worry about out-of-pocket expenses. However, Plan F is no longer available to any Medicare beneficiary who became eligible for Medicare on or after January 1, 2020.
Due to these enrollment restrictions, Plan G is becoming the most popular Medicare Supplement plan type for new Medicare enrollees, as it covers the most Medicare costs of any Medigap plan type that’s available to all beneficiaries. Plan G beneficiaries only have to pay their annual Medicare Part B deductible, after which the plan provides 100% coverage on all Medicare-covered medical expenses.
Lastly, Plan N is the third most popular type of Medicare Supplement plan, which supports enrollees interested in a broad range of coverage. It provides 100% of Medicare Part B coinsurance costs, with the exception of $20 copays for office visits and $50 copays for emergency room (ER) visits. Beneficiaries are responsible for the annual Part B deductible as well. This structure keeps the cost of the plan relatively low despite risking higher out-of-pocket expenses, which is why it’s generally preferred by those with fewer medical needs.
Medicare Supplement plans offer various attractive components, as well as other features that may not fit your needs or preferences. Consider both the benefits and drawbacks below before enrolling in a Medigap plan.
One of the primary benefits of Medicare Supplement plans is that they help mitigate the costs of health care not covered by Original Medicare, such as copayments, coinsurance and deductibles. Any Medicare beneficiary who’s concerned about incurring potentially high out-of-pocket costs should consider Medigap plans and how they can help cover these expenses.
Some Medicare Supplement plans also provide coverage for services that Original Medicare doesn’t cover, such as medical care needed during travel outside the U.S. Medicare enrollees who enjoy frequent travel often enjoy the additional layer of protection.
Though Medicare Supplement plans offer several benefits, there are a number of drawbacks to consider as well. Medigap plans sold after 2005 don’t include prescription drug coverage, meaning beneficiaries who take prescription medication may also need to enroll in a r Medicare Part D plan.
Additionally, Medigap doesn’t cover long-term care, such as nursing homes, private-duty nursing, services for vision or dental, eyeglasses or hearing aids.
It’s also important to keep in mind that you’ll have to pay a monthly premium for your Medigap plan in addition to the Part B monthly premium you pay to Medicare.
Medicare Advantage plans serve as a substitute for Original Medicare, providing that same coverage plus additional benefits like prescription drugs coverage (Part D). Meanwhile, Medicare Supplement plans, or Medigap plans, are sold by private insurance companies to people enrolled in Original Medicare to help fill the gaps of that coverage.
The 10 types of Medigap plans provide standardized coverage to beneficiaries nationwide and help pay for things like deductibles, coinsurance and copays. Because plan coverages are standardized, only monthly premium rates vary from provider to provider. It’s also important to note that Medigap policies don’t cover prescription drugs. A person enrolled in Original Medicare who wants prescription drug coverage needs to purchase a separate Medicare Part D plan in addition to any Medicare Supplement plan.
Meanwhile, Medicare Advantage policies are only standardized in that they must provide the same benefits of Original Medicare, as the plans serve as a direct substitute. After this threshold is met, private insurance providers can add any number of benefits and services to a plan—prescription drugs, dental care, vision care and more—to make them more comprehensive (and often more expensive). Monthly premium rates for Medicare Advantage plans tend to vary dramatically based on location and the list of benefits provided.
Signing up for a Medigap plan is easy. “Medicare supplements may be bought through an agent or from the carrier directly,” says Corujo. Since there’s no annual open enrollment period, you may join at any time.
To buy a Medigap policy, it’s best to enroll during your Medigap Open Enrollment period, which lasts six months. This period begins the first month you have Medicare Part B and are 65 or older. You can buy any Medigap policy sold in your state during this time, even if you have health problems.
Follow the steps below to purchase your Medigap plan:
The best time to enroll in a Medicare Supplement plan is during your initial Medigap Open Enrollment Period, the six-month window that begins on the first day of the month in which you’re both 65 or older and enrolled in Medicare Part B. This enrollment period is the only timeframe in which insurance companies cannot deny you a policy based on your health status or any medical condition.
Source: Forbes
