Changes To Be Aware Of
Effective January 1, 2020 - Plan C and Plan F
Starting January 1, 2020, Medigap/Medicare Supplement plans sold to people new to Medicare won’t be allowed to cover the Part B deductible. Because of this, Plans C and F will no longer be available to people who are new to Medicare on or after January 1, 2020.
If you already have either of these two plans (or the high deductible version of Plan F) or are covered by one of these plans prior to January 1, 2020, you'll be able to keep your plan. If you were eligible for Medicare before January 1, 2020 but not yet enrolled, you may be able to buy one of these plans.
People new to Medicare are those who turn 65 on or after January 1, 2020, and those who get Medicare Part A (Hospital Insurance) on or after January 1, 2020
Additional Plans That Have Seen Changes...
Plans E, H, I, and J are no longer sold, but, if you already have one, you can generally keep it.
Plans D and G with coverage starting on or after June 1, 2010, have different benefits than Plans D or G bought before June 1, 2010.
Insurance companies selling Medigap policies are required to make Plan A available. If they offer any other Medigap policy, they must also offer either Plan C or Plan F to individuals who are not new to Medicare and either Plan D or Plan G to individuals who are new to Medicare.
Not all types of Medigap policies may be available in your state.
For More Information see the CMS 2021 Choosing a Medigap Policy booklet.
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Frequently Asked Questions
Q : Why do I need a Medicare Supplement Insurance plan?
A : Once Original Medicare pays it's portion of your health care expenses, you are then responsible for any "gaps" in coverage (co-pays or deductibles not covered by Medicare). Medicare Supplement Insurance policies, commonly referred to as "Medigap" plans, pay only for services that Medicare considers medically necessary. These payments are based on the Medicare-approved charge. Depending on the plan you select, the policy may not fully cover all of your medical costs. With Original Medicare only, you could face very hefty out of pocket expenses.
Q : What are the most popular Medicare Supplement Insurance plans?
A : The most popular Medicare Supplement plan for now remains the Plan "F" due to "first dollar coverage" and limited out of pocket expense for hospital and doctor. However, those turning 65 on or after January 1, 2020 can no longer sign up for Plan "F" or "C" coverage. If you currently have Plan "F" or "C" you can keep it, or if you turned 65 prior to January 1, 2020 or qualified for Medicare due to a disability prior to January 1, 2020, you can still purchase Plan "F" or "C". Basic coverage with Plan "G" now mirrors plan "F" with one exception. With Plan "G", you are responsible for the Part B Medicare Deductible (for most people, this is $198 in 2020). The difference in premium between F and G also make G the more economical choice between the two. The Plan "N" Medicare Supplement is also a more affordable alternative with some cost sharing involved. "N" can save you up to 35% or more in premium compared to the plan "F".
For a more detailed explanation of Medicare Supplement plan coverage
please see the chart on the "Medicare Supplement" page.
Q : Am I limited to a network of hospitals and doctors for service?
A : No. This is one of the reasons many people prefer a Medicare Supplement Insurance plan to Medicare Advantage (which can be much more restrictive). With a Medicare Supplement, you have the flexibility to choose any hospital or doctor who accepts Medicare.
Q : Are there specific dates for enrolling in or changing a Medicare Supplement?
A : No. A Medicare Supplement may be changed at any time. However, you could be subject to medical underwriting unless you are in an open enrollment or guaranteed issue period.
Q : What is open enrollment and a guaranteed issue period?
A: Open enrollment for those 65 and older is six months after you sign up for Medicare Part B. You can can qualify for the Medicare Supplement plan of your choice with no medical underwriting. Check state availability for those qualifying for Medicare prior to age 65 due to disability. You can qualify for a guaranteed issue policy due to a loss of coverage with Medicaid, Medicare Advantage, PACE or group coverage. You must apply within 63 days of the date of termination of previous coverage in order to qualify as an eligible person.
For a more detailed explanation of a guaranteed issue situation, please click here.
Q : How do you qualify for a Medicare Supplement?
A : You must have both parts A and B of Medicare. This usually occurs when an individual turns 65 or qualifies for Medicare through a disability prior to age 65.
Q : Is a physical necessary to enroll in a Medicare Supplement?
A : No. If you are beyond open enrollment or do not qualify during a guaranteed issue period, you will only need to answer health questions on the application. Medical underwriting yes... a physical, no.
Q : How do I pay my premiums?
A : The majority of companies require a bank draft if paying on a monthly basis. Direct billing is more common with payments on a quarterly, semi-annual or annual basis.
Q : Will my premium change?
A : Most Medicare Supplements are "attained-age" policies which means your premium will increase as you age. Also, look for annual premium adjustments to reflect changes in Medicare.
Q : With plans now standardized/modernized are prices about the same with all companies?
A : No. Even though basic coverage is the same, the price can vary greatly based on zip code. Now more than ever it pays to consider price when shopping for a Medicare Supplement. At the same time, you need to make sure the company you choose is financially sound with easy access to customer service. All of the Medicare Supplement companies we represent fit this criteria and deliver exceptional customer service.
Q : Is a lot of paperwork involved in filing a claim?
A : No paperwork. All of the companies we represent file claims electronically. Once your provider bills Medicare, your supplement is notified, which will then trigger payment on the part they are responsible for (which, of course, is determined by which plan you are enrolled in).
Q : Will a Medicare Supplement plan cover prescription drugs?
A : No. You will need a separate Part D Plan for prescription drugs. (not to be confused with a Medicare Supplement Plan D)
Q : How do I apply for coverage?
A : It is a very simple process. Let's determine the plan and company that is right for you. With most plans we can complete an electronic application, a telephone application directly with the company or a paper application that can be take over the phone and either faxed or mailed to you.
Just a few minutes is all it takes!
Medicare Supplement Open Enrollment
- Enrolled under an employee welfare benefit plan that either: (1) supplements Medicare, and the plan terminates, or the plan ceases to provide all such supplemental health benefits; or (2) is primary to Medicare and the plan terminates or the plan ceases to provide all health benefits to the individual because the individual leaves the plan; or
- Enrolled in a Medicare Advantage plan or Program of All-Inclusive Care for the Elderly (PACE) and the organization's certification or plan is terminated or specific circumstances permit discontinuance including, but not limited to, a change in residence of the individual, the plan is terminated within a residence are, the organization substantially violated a material policy provision, or a material misrepresentation was made to the individual; or
- Enrolled in a Medicare risk contract, health care prepayment plan, cost contract or Medicare Select plan, or similar organization, and the organization's certification or plan is terminated or specific circumstances permit discontinuance including but not limited to, a change in residence of the individual, the plan is terminated within a residence are, the organization substantially violated a material policy provision , or a material misrepresentation was made to the individual; or
- Enrolled in a Medicare Supplement policy and coverage discontinues due to insolvency or other involuntary termination of coverage under the policy, substantial violation of a material policy provision, or material misrepresentation; or
- Enrolled under a Medicare Supplement policy, terminates and enrolls for the first time in a Medicare Advantage plan or PACE provider and then the insured person terminates coverage within 12 months of enrollment; or
- Upon first becoming eligible for benefits under Part A at age 65, you enrolled in a Medicare Advantage plan or PACE provider and then you dis-enroll within 12 months; or
- Lost eligibility for health benefits under Medicaid.