What exactly is a Medicare Supplement Plan?

A Medicare Supplement (also known as a Medigap plan), is a supplemental health insurance plan designed to work as a secondary coverage to traditional Medicare. With this type of plan, you can choose any doctor you’d like without a referral, as long as they accept traditional Medicare. This means there is no strict network to work within, and you have the freedom to see the providers you prefer. For example, Baylor Scott & White, Texas Health, Medical City, and Lake Granbury Medical Center all accept traditional Medicare, and therefore work with a Medicare Supplement.

While these plans are offered by private insurance companies, the benefits are standardized. The two most popular Medicare supplement plans in Texas are Plan G and Plan N. This means that every Medigap Plan G pays the exact same benefits and you can visit the exact same doctors and hospitals as any other Plan G. The same goes for Plan N. As long as you purchase your Medigap plan from a reputable company, you can be confident that the benefits will be the same. Therefore, working with an independent insurance agency like Patriot Insurance Services allows you to shop many different Medicare Supplement companies to find the best price!

What is the difference between Medicare Supplement Plan G and Plan N?

This is often a tough decision for Medicare beneficiaries, so how do you choose? Lets break it down simply:

Benefits:

Plan G is very simple to understand; it pays every medical cost left over after traditional Medicare pays first, except the yearly Part B deductible. So you pay the yearly deductible, and then your supplement Plan G pays 100%.

Plan N is very similar to Plan G, except you also pay a $20 copay for doctor visits, a $50 copay for ER visits, and the Plan N does NOT cover the Part B excess fee of 20%. For this reason, I typically recommend Plan G.

Price:

Plan N will typically cost less on a monthly basis than a Plan G, because it offers less benefits. Depending on how often you see the doctor, these monthly savings may be right for you. However, paying more for a Plan G will provide the most comprehensive coverage. In Hood, Parker, Erath, Johnson, and surrounding counties, you can find a Plan G for around $115 per month and a Plan N for around $90 per month, depending on your age and sex.

Common questions regarding Medicare Supplement or Medigap plans:

  • As you as your doctor takes original Medicare, they must accept your Medicare Supplement plan. Medicare pays first, and the remainder is sent to your Supplement. There are no HMO or PPO network restrictions with a Medigap plan.

  • The short answer is yes, Medicare Supplement plans have yearly rate increases. However, the cost will never go up according to your personal claims history. Medicare supplements are priced based on groups. For example, if medical claims spike for all people in Texas that are on that particular Medicare supplement, it will effect the rate increase for everyone that year.

  • No! You cannot have both a Medicare Advantage plan and a Medicare Supplement Plan G at the same time. Therefore, it is VERY important to speak with an agent to determine which one is the best fit for you and your situation.

  • Generally speaking, you will need to choose a standalone Part D prescription drug plan in addition to the Medicare Supplement, because drug coverage is not included on a Medigap plan.