Medicare Supplement insurance plans function alongside Original Medicare (Part A and Part B) to help cover cost gaps, such as copays, deductibles, and other out-of-pocket expenses. These supplemental plans reduce your out-of-pocket costs, saving money if you’re worried about healthcare costs on Original Medicare.
Medigap works only with Original Medicare, not with Medicare Advantage. It also doesn’t replace Original Medicare. Like Original Medicare, Medigap allows you to see almost any doctor without restrictions (such as prior authorization) in most cases.
Medigap Advantages
About 98% of doctors accept Original Medicare, and pairing it with a Medicare Supplement allows you to see any provider who takes Medicare. Medigap may be best for those who
- Are enrolled in Original Medicare (required)
- Travel domestically often or split time (snowbird) between states
- Want maximum provider flexibility without network restrictions
- Have chronic health conditions and need predictable costs
What Medigap Covers
Private insurance providers sell Medicare Supplement insurance plans, also known as Medigap plans. The plans cover costs not covered by Original Medicare (Part A and B). Plan cost coverages include:
- Coinsurance and copays for hospital care and doctors’ visits
- Copays and coinsurance for hospice care and skilled nursing facilities
- Pints of blood
- Up to 80% of international travel emergencies
The only thing most Medigap plans don’t cover is your deductible, unless you’re lucky enough to be grandfathered into an older plan’s eligibility. Call me to learn if you’re eligible.
California Medigap Plans
If you’re looking for a California Medigap plan, you likely already know how Medigap creates predictable costs. But you might not realize that California’s Medicare Supplement Plans provide you with an extra consumer protection. Due to the California “Birthday Rule,” you can switch to an equal or lesser plan without underwriting on your birthday.
And of course, Medigap allows you to see any provider in the U.S. that accepts Medicare—even if you’re traveling outside of California or living a snowbird life.
As a licensed independent professional, I’d say this is one of the real consumer advantages of living in the Golden State. Not all states offer a Birthday Rule or similar protections. Call me to discuss California-specific Medicare Supplement rules.
Popular Medigap Plans
Medicare Supplement Insurance Plans are recognized by letters such as Plan A, and the popular Plan G and Plan N. The plans are standardized, so one insurer’s Plan G has the same benefits as another insurer’s.
Here are a few of the most popular plans I see among clients in California:
- Plan G: Covers nearly all out-of-pocket costs not covered by Original Medicare.
- Plan F: Not available to all beneficiaries, but does cover Part A and Part B deductibles
- Plan N: Similar to Plan G but often with lower premiums and higher copays
- Plan C: Not available to all beneficiaries, but does cover Part A and B deductibles
- High-Deductible G: Similar to Plan G, but lower monthly premiums combined with a higher deductible to meet first
How I Help with Medicare Supplement Plans
Medigap benefits are standardized, but companies can charge very different premiums for those same benefits. I can compare multiple carriers to find competitive pricing for your ZIP code and offer insights into which lower-priced plan may increase in the future based on your age or other factors.
Medicare Supplement (Medigap) plans are just one type of California Medicare Plans that are available. Let’s discuss your unique situation to see if this is the best fit for you. I can help you understand and use the unique benefits of California Medigap plans, particularly those available in Woodland Hills, Tarzana, Calabasas, Thousand Oaks.