What Is the Cost of Supplemental Health Insurance?

Medigap Made Easy

Are you new to Medicare? Trying to figure out the cost of supplemental health insurance for seniors? Look no further! HealthMarkets has the information you need, whether it’s for supplemental health insurance or Medigap.

The answer really depends on what you are looking for: supplemental health insurance plans designed for seniors or Medicare supplement plans. Although they are often confused because of their similar terminology, they are very different. So let’s review the differences between these two lines of products.

Senior Supplements

Senior supplements are supplemental health insurance plans designed specifically to meet seniors’ needs. Supplemental health insurance includes products like dental, vision, and life insurance. These plans are sold by private health insurance companies and are not Medicare. They can be purchased at any time, though there are age restrictions to certain products (like life insurance).

Medicare Supplement Plans (Medigap)

Medicare supplement plans are related to Medicare. Like Medicare’s “Parts”, each plan letter offers different benefits and has a different premium amount. They are designed to fill the “coverage gaps” in Original Medicare benefits (hence the name Medigap). These products will cover healthcare expenses otherwise left out of Original Medicare coverage, like coinsurance and deductibles. However, Medigap plans do not include dental, vision, or any other supplemental health insurance benefits.

Medicare Supplement Plans – Medigap

Medicare Supplement Plans, also known as Medigap, are standardized by the Federal Government. They are labeled A, B, C, D, F, G, K, L, M, and N. Each standardized Medigap policy must offer the same basic benefits no matter which insurance company sells it. Cost is usually the only difference between Medigap policies with the same letter sold by different insurance companies. Plan A pays the Medicare hospital and physician coinsurance, the first three pints of blood, and 365 days of hospitalization beyond Medicare. Plans B through N provide these benefits and add more benefits such as coverage for Medicare deductibles, excess charges and limited preventive care, and foreign travel. You can only have one Med Sup plan. No one should try to sell you an additional Medsup plan unless you decide you need to switch policies.

Note: Medicare Plan F is no longer available to those who are eligible for Medicare after January 1, 2020.

Open Enrollment for Medicare Supplemental Insurance is at age 65 for all consumers, including those already receiving Medicare due to disability. The Open Enrollment period is a six-month period. For six months beginning when you are both age 65 or older and enrolled in Medicare Part B, companies must sell you any Medicare supplement plan they offer. After this limited open enrollment period, companies can pick and choose whom they will cover and how much they will charge based on your health. If you have an individual or “bank group” insurance policy, becoming Medicare eligible does not require you to cancel it and purchase a Medicare supplement. Doing so may save premium costs but it is important to compare benefits before deciding which will work best.

If you are eligible for employer retirement insurance, review the plan carefully to understand what benefits are available and how it works with Medicare. Be aware that employer plans are not standardized and are not subject to the requirements governing standardized Medicare supplement policies. Also, it is important to remember, if you leave an employer plan you may not be able to go back on it.

What Is the Cost of Supplemental Health Insurance?

The average cost of supplemental health insurance for seniors will depend on the health insurance company, type of plan, and benefit level you select.

Medigap Costs vs Benefits

But don’t just focus on the cost of a Medigap plan. The least expensive plan may not offer all of the “gap” coverage you expect. Before deciding on a plan simply because of the average cost of supplemental Medicare insurance (Medigap), make sure you are comparing the benefits offered by each plan as well.

Some Texas residents are eligible to enroll in approved Medicare Advantage plans. These plans are offered by private insurance companies. Each year Medicare Advantage companies decide where they will offer their plans, what benefits will be offered, and what the premiums will be. Several include vision, dental, hearing, and wellness programs not covered by original Medicare. As noted earlier many Medicare Advantage Plans also offer prescription drug coverage. There are several Medicare Advantage plans available in Dallas, Tarrant, and surrounding counties. Depending on plan choice, a member may be responsible for paying co-payments for certain covered services. Most importantly, with Medicare Supplements, Medicare Advantage, and standalone Part D Prescription Drug Plans, you must continue to pay your Part A (if any) and part B Medicare premiums.

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Sarah began working in the healthcare industry in 2001, where she worked for many years with elderly Alzheimer and Dementia patients. From there she worked as a Group Benefits Administrator with a local healthcare company in the Human Resource Department for a period of 10 years. Since then, she has decided to work in the Medicare insurance industry full time and has joined the family business, Ashford Insurance, as a Medicare Insurance Agent.