What is Medicare Supplement Insurance?
Medicare Supplement plans, commonly known as Medigap, are sold by private insurance companies to help pay for healthcare costs that Original Medicare (Part A and Part B) doesn't cover. This includes copayments, coinsurance, and deductibles.
Unlike Medicare Advantage, Medigap plans work alongside Original Medicare — not as a replacement. You keep your Original Medicare and add a supplement plan on top of it for additional financial protection.
Standardized Plan Letters
Medigap plans are standardized by the federal government and labeled with letters. Each letter offers a different level of coverage. The most popular plans in Utah include:
- Plan G — The most comprehensive plan available to new Medicare enrollees. Covers nearly all out-of-pocket costs except the Part B deductible. Learn more about Plan G.
- Plan N — Similar to Plan G but with lower premiums. You may pay small copayments for some office visits and emergency room trips.
- Plan A — The most basic plan. Covers Part A coinsurance and hospital costs, Part B coinsurance, and the first three pints of blood.
- Plan F — Was the most popular plan but is no longer available to those who became eligible for Medicare after January 1, 2020. If you were eligible before that date, you may still enroll.
Medigap vs. Medicare Advantage
This is one of the most important decisions you'll make with Medicare. Key differences:
- Medigap works with Original Medicare — you can see any provider that accepts Medicare nationwide. You'll need a separate Part D drug plan.
- Medicare Advantage replaces Original Medicare — you use a network of providers. Most plans include drug coverage and extra benefits.
- Medigap plans generally have higher monthly premiums but more predictable out-of-pocket costs.
- Medicare Advantage plans often have lower premiums but may have copays and network restrictions.
Enrollment in Southern Utah
The best time to enroll in a Medigap plan is during your Medigap Open Enrollment Period, which starts the month you turn 65 and are enrolled in Medicare Part B. During this 6-month window, insurance companies cannot deny you coverage or charge you more due to pre-existing conditions.
If you miss this window, you may still be able to enroll, but the insurance company can use medical underwriting to determine your eligibility and premium.