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Medicare Supplement Plans

How to Shop Plans – 3 mins

Plans F & G – 3:14min

Plans N & HDG/HDF – 9:57min

Summary & Sample Rates – 4:54min

Medicare Supplement Plans (otherwise known as MediGap Insurance) are secondary to Medicare A and B.   They work with Medicare to pay your deductibles, copays, and coinsurances from Medicare A & B.

Medicare Supplement Plans are easy to shop for because:

  1. No difference in benefits.
    • The benefits are the same with every insurance company.
    • If you are interested in a Plan G, for example, Plan G benefits are exactly the same with every insurance company that offers plan G.
  2. No difference in claims approvals.
    • Since Medicare is primary, Medicare A and B make all claims decisions.  If Medicare says your service is covered, the Supplement (Medigap) Plan is required to pay their portion of the bill.
    • You will NOT see one company paying more or less claims over another company.
  3. No difference in Networks
    • Medicare Supplement Policies have No doctor network.
      • As long as your doctor accepts Medicare, they will except any Medicare Supplement plan.
        • When you call your doctor, you do not say “do you accept my ABC Medicare Insurance”, instead say “do you accept Medicare?” 
        • Many providers accept Medicare. Participating provider search tool.

Shop Price and Insurance Company Reputation

Did you receive Medicare Supplement Quotes from HTA?  Learn more about How to Read your Medicare Supplement Quotes.

Medicare Supplement Available Plans

There are 10 different Medicare Supplement plans available.  They are all labeled with letters Plans A, B, C, D, G, F, J, K, M, N (Plan G and F also has high deductible options).

Many clients prefer Plan F, G, N or High Deductible G.

MA, MN and WI are the only states that do not follow the standardized plans.  These states have their own unique plan benefits available.  Please talk with your HTA Client Services Representative to get more details on plans in these states.

More on Plans F and G

These plans provide the lowest out of pocket risk on major medical expenses.  Click on the links to see the Plan Outline of Coverage.

  • Plan F
    • You pay $0 for ALL Medicare Eligible expenses
  • Plan G
    • You pay the Part B deductible of $226/calendar year (in 2023)
    • Then you pay $0 for ALL Medicare Eligible expenses for the reminder of the calendar year.

Plans F, HDF (High Deductible F), G and HDG (High Deductible G) are the only plans that provide coverage for “Part B Excess”. 

More on Plans N and High Deductible (F or G)

These plans provide lower premium alternatives to Plan F or G without moving to Medicare Advantage Insurance.  Click on the links to see the Plan Outline of Coverage.

  • Plan N
    • You pay your Part B calendar year deductible of $226.
    • After your deductible, you pay up to $20 Doctor Copay, $50 Emergency Room Copay.
    • After your deductible, you pay up to 15% Charge in Excess of the Medicare Allowable amount- no cap
  • Plan High Deductible F–    or
  • High Deductible G
    • You pay all Medicare A and B out of pocket expenses
      • Part A per admission deductible of $1600.
      • Part B calendar year deductible of $226.
      • Part B 20% coinsurance + up to 15% in Excess Charges
    • Until you reach out of pocket max of $2,700
    • Then you pay $0 for ALL Medicare Eligible Expenses for the remainder of the calendar year.

Excess Charges

Doctors are permitted to charge up to 15% more than the Medicare approved amount for services.
Seven states have banned excess charges, meaning the providers in these states cannot charge more than the Medicare-approved amount unless they have opted out. These states are:  CT, MA, MN, OH, PA, RI, VT

  • Additionally, New York has a statewide limiting charge of 5%. This means providers in New York can only charge 5% more instead of 15%.
  • ALL other states, Medicare Part B providers can charge up to 15% more than the Medicare allowable amount for services.
  • If you live in a “Non-Excess” state but go to a Part B provider in an “Excess” state you will be exposed to potential Excess charges.

Plans F, HDF (High Deductible F), G and HDG (High Deductible G) are the only plans that provide coverage for “Part B Excess”. Plan N does not provide coverage for excess charges. 

Underwriting Considerations

Medicare Supplement Insurance has an Open Enrollment Period for the first 6 months in which you are enrolled in Medicare Part B.  During this time, you will be able to purchase ANY Medicare Supplement Plan with no medical underwriting.  After this 6 month period ends, you will be medically underwritten if you want to purchase a Medicare Supplement or change Medicare Supplement Plans or insurance companies.

  • About 10 states have exceptions to these rules.
  • Also, if you are already on Medicare Part B (for more than 6 months), but lose your group coverage, you will have SOME plans available on a Guaranteed Issue basis.  There will be less options available which do not require you to answer medical questions to qualify.

Medicare Advantage Plans and Medicare Prescription Drug Plans provide an Initial Election Period when you enroll in Medicare, a Special Election Period when you come off your group coverage plan (Employer Coverage, Cobra, Retiree, Severance), and also allow you to change plans once a year during the Annual Election Period (October 15th through December 7th) without medical underwriting.

MS and MA Differences – 15 mins

Should I consider a Medicare Advantage Plan rather than a Medicare Supplement Plan?

Please watch the video to the left to review the differences between Medicare Supplement (MediGap) and Medicare Advantage (Part C).

If you are interested in considering Medicare Advantage instead, please click on the link to visit our Medicare Advantage educational webpage.