Medicare Supplement 101

Medicare doesn’t cover everything. There are some gaps in coverage, and some of them are potentially very large.

We have seen how some Medicare beneficiaries choose an HMO or PPO under Medicare Advantage (MA) to get additional coverage.

However, Medicare supplement plans (Medigap) have some unique features which make them appealing to many people.

With a Medigap plan, you can go to any doctor in the US that accepts Medicare. This is a huge difference from many MA plans. Many MA plans require you to choose a doctor in their network and benefits may be much more expensive or not available if you see a doctor outside the insurance carrier’s network.

This can also be a significant factor when travelling. If you want to visit a doctor that is outside of your local area, you may not have coverage thru an MA plan. Or if you want to see a specialist in another state that is highly regarded for treating the condition you have, you may not be able to under an MA plan.

Medigap plans are standardized by law and this makes it easy to compare what each insurance carrier offers.


* Plan F also offers a high-deductible plan. If you choose this option, this means you must pay for Medicare-covered costs up to the deductible amount of $2,180 in 2016 before your Medigap plan pays anything.

** After you meet your out-of-pocket yearly limit and your yearly Part B deductible, the Medigap plan pays 100% of covered services for the rest of the calendar year.

*** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in inpatient admission.

You live in Massachusetts, Minnesota, or Wisconsin

If you live in one of these 3 states, Medigap policies are standardized in a different way.

For detailed answers to your questions, a licensed agent at the private Medicare Helpline can assist you and guide you thru comparing benefits and costs of available plans in your area at 1-855-MEDICARE or contact us via the web: