Medicare Supplements - What are they?
Is a Medicare Supplement Plan Good for You?
Navigating healthcare coverage during retirement involves understanding various plan options and details, which can be complex. For individuals nearing Medicare eligibility, it is important to compare standard Medicare coverage with supplemental options to identify the best fit for your needs. Medicare Supplement plans are available to address some of the costs not covered by traditional Fee For Service (FFS) Medicare.
Medicare Supplement plans, also known as Medigap, help cover the 20% of medical costs that traditional FFS Medicare (Parts A and B) does not pay, as well as deductibles for Parts A and B. These plans do not include Part D prescription drug coverage; a separate plan must be purchased if prescription coverage is needed. Dental, vision, and hearing benefits are typically excluded from both traditional Medicare and most supplement plans, although some insurers may offer these benefits as additional options.
Supplement plans allow beneficiaries to visit any provider nationwide who accepts Medicare, and most plans also cover 80% of foreign travel emergencies up to plan limits. Availability of specific plans varies by region. Currently, Plan G and Plan N are among the most commonly selected options. Plan G covers all Part A and B services except for the Part B deductible. Plan N covers all Part A and B services except for deductibles and certain copayments related to office and emergency room visits and does not cover Part B excess charges. Neither plan have out-of-pocket or lifetime limits.
The core benefits of these plans remain generally consistent across different insurers, though minor differences may exist, and premium rates vary depending on age, gender, carrier, and location. For instance, in the Philadelphia metro area, average monthly premiums for Plan G are $150 for 65-year-old males and $130 for females. Plan N averages $125 for males and $110 for females. The High-Deductible Plan G, with a $2,870 Part B deductible for 2025, has lower premiums—$80 per month for males and $50 for females. Beneficiaries are still responsible for paying Part B and, if applicable, Part A premiums.
Enrollment is possible during the initial enrollment period or a Special Enrollment Period (SEP), with guaranteed issue regardless of health status during these times. Afterward, insurers may require medical underwriting based on their own criteria. Policies remain renewable as long as premiums are paid.
Individuals considering healthcare options after Medicare enrollment may find that a Medicare Supplement plan addresses specific coverage needs. For further information or to obtain a free quote, contact Health Insurance by Mike Fisher at (610) 420-6064.
