Medicare Questions & Answers: Medicare Supplement
Medicare Supplement Q&A
Showing 24 questions
Do I have to answer health questions when switching from one Supplemental/Medigap plan to another?
In most cases, yes, you will have to answer health questions when switching from one Supplemental/Medigap plan to another. However, there are certain situations where you may qualify for guaranteed issue rights, which means you can switch plans without having to answer medical questions or go through underwriting.Guaranteed issue rights typically apply if you’re losing other coverage, moving out of your plan’s service area, or switching within your Medigap trial period, among other special circumstances. It’s always best to review your specific situation to determine whether you qualify for guaranteed issue or if underwriting will be required.
Can I change my Supplemental/Medigap plan at any time?
Medicare Supplement plans can be changed anytime, however, they may be subject to underwriting depending upon the time period that you’re trying to enroll.
Which Medicare Supplement plan (Medigap) offers the best value for most seniors, and why?
Plan G is usually the best value for most seniors. It covers almost everything except the Part B deductible, making it a solid choice for predictable costs and great coverage. It’s popular because it offers the most benefits without the high premiums of Plan F. (Which is only available for those eligible for Medicare before 1/1/2020) Plus, once the deductible is paid, there are no copays or surprise bills.
Can I switch from a Medicare Advantage plan to a Supplemental/Medigap plan during the Annual Enrollment Period without answering health questions?
The short answer is no. However, there are always exceptions such as a Special Enrollment Period (SEP) to make a change or within your 12-month trial right period, or you are involuntarily terminated from your Medicare Advantage plan due to moving out of the plan service area, gaining eligibility due to age (turning 65), to name a few. In these cases, I want to discuss the change and ensure we cover all available SEP options.
Is paying for a high-end Medicare Supplement plan really worth it, or is it overkill?
I believe buying the best Medicare Supplement plan available is the smart move. It costs more upfront, but the lower financial exposure and stronger benefits outweigh the savings from cheaper plans with weaker coverage. Most clients I’ve guided find the trade-off worth it when they need serious care. You’re not overpaying—you’re securing peace of mind.
My neighbor says I'm crazy for paying for a Medigap plan when Medicare Advantage is "free." What should I tell him?
I help folks in Michigan and after your initial enrollment into medicare here, you will have to health qualify for medigap(supplemental) plans. With our health you never know what is around the corner. If serious health issues wiping out your savings is a concern...and it should be. Medigap plans are the safest option.
I'm enrolled in a Medigap Plan F, and I'm not sure how my emergency room visits are handled. Is there a copay I should expect?
With your Medigap Plan F, there should not be any cost for an emergency room visit unless you are traveling outside of the U.S. Plan F will then cover 80% of most of your medical expenses for international travel, provided they accept Medicare. If not, you may need to file it with your insurance when you return to the States to recover your cost. There is a lifetime maximum on international travel expenses.
I'm on Medigap Plan G, and I'm curious how my upcoming knee replacement surgery will be billed. Does the plan cover it all after my deductible?
If you’ve already met your deductible then you’re covered at 100%. If you have not met your deductible, then it will be covered after the deductible at 100%. If the facility you go to says “if you pay this much now, we cut this much off your bill”. Do not do this. Tell them to just bill the insurance. If you get a bill in the mail, don’t just pay it. Providers bill patients before insurance even knows they have a claim and it’s often more than you would owe if you hadn’t met your deductible. Call the company billing you. Tell them you have a Plan G and you won’t owe what they’re billing and wait for an Explanation of benefits before paying what would be your deductible assuming you have not already met your deductible. You’ll owe nothing if you’ve already met it.
How can I save money on my Medicare Supplement?
If you're on a Medicare Supplement or considering a Medicare Supplement you might have noticed that supplement rates have gone up every year for the last three years. The reason that they have gone up is that Medicare raised all its deductibles and copayments for Medicare Parts A and Part B. There is a solution to keep from paying the insurance companies thousands of dollars each year for services you are not using. I will try to explain an alternative that will lower your monthly premiums 75 percent or more of what you are currently paying. The solution is to purchase a HDF or HDG supplement. You may have not heard of a HDF or HDG supplement, that is because there are only a handful of companies that offer the HDF or HDG supplement. The HD stands for "High Deductible", it is the maximum annual deductible you would have to pay out of pocket in a calendar year. After all copayments reach the deductible, Part A and Part B would be covered 100%, meaning that you would have no more out of pocket cost for the rest of the year. The annual deductible is set by the federal government and for 2024 is currently $2800.I went with Medigap because I travel a lot, but now I'm paying a fortune in premiums. Did I make a mistake?
Medigap gives you total independence to go wherever they accept Medicare without worrying about any additional unforeseen charges, and this does come with the upfront price, but it gives many people peace of mind. This is often referred to as "pay upfront and forget about it, or pay as you go." It is important to note that a good agent will evaluate the carrier's past history and can give you a report of the premium increases they have had, often they have had them, and the rate within the health industry that they carry. This is important when you first begin your insurance coverage.
I'm on a supplemental Plan N, and I'm curious if my recent MRI is covered or if I'll get stuck with a big bill.
With your Medicare Supplement Plan N, your recent MRI is covered under Medicare Part B as long as it’s deemed medically necessary, but you’ll need to meet the 2025 Part B deductible of $257 first, and then Plan N picks up the 20% coinsurance—though you might face a small copay, up to $20, if it’s done in a doctor’s office. Unlike Plan G, which also covers the Part B coinsurance but skips those copays and fully handles excess charges if a provider bills above Medicare’s rate, Plan N leaves you responsible for any excess, though that’s rare with MRIs since most imaging centers stick to Medicare-approved amounts. I’ve seen beneficiaries caught off guard by these details, so double-check your provider’s billing with your Explanation of Benefits to avoid surprises—either way, your bill should stay manageable compared to having no supplement at all.
I've got Medigap Plan C, and I'm curious if my recent bloodwork is included or if I need to budget for extra costs.
This is no such thing as "Medigap Plan C". If you have a Medicare Part C Advantage plan, bloodwork / lab expenses will be plan dependent but many plans feature $ 0 copay (or low cost) for these services which can vary based on where the blood is drawn: doctor's office, clinic, hospital or other stand-alone facility.
How do I know if a Medigap policy is right for me, and what's the best time to buy one?
A Medigap policy is right for you for a number of reasons:1. You are in the younger market like age 65 and that gives you a low premium.
2. You're health is not great, many doc visits, maybe a few chronic conditions requiring on going services.
3. Medigap policies follow Medicare's lead, and Medicare patients are treated everywhere. In other words, Medigap clients don't hear "no" when or if they want to go to a specialist locally or anywhere in the country.
If Medicare Supplement (Medigap) plans are better for long-term coverage, why don't more people choose them?
Medicare supplement plans are generally much lower cost for people age 65 - to - 70 but after that, things change. I have customers who started paying $ 125 monthly for their supplements but their plans closed for new business and increased premiums on current grandfathered members to $ 500 monthly (and higher).
What's your go-to strategy for helping someone decide between Medicare Advantage and Medigap?
I have a seven question algorythm that is 99% accurate. Seven questions and the appropriate strategy is evident.
I just moved from New York to Florida and have Original Medicare with a New York Medigap plan. Do I need to change my coverage?
You don't have to, but it is to your advantage to do so! I am a licensed Fl agent, and can explain it to you should you reach out to me. The plan itself most likely won't change, but the amount leaving your bank account will!! - Norman Smith
What's the best way to compare my current Medicare supplement plan to a Medicare advantage plan?
I always tell my clients to count up the cost. Write down all the out-of-pocket cost to have a Medicare Supplement plan and what your cost will be if you sign up for a Medicare Advantage plan. If you would like to discuss and compare plans, you may give Melissa Barton a call at 473-242-8437.
I missed my Medigap window by a few months and now no one will cover me without underwriting. Why isn't this rule more well known?
The first thing that comes to mind is that you probably did not meet with a long-time Medicare professional agent who knows the ins & outs of its very quirky rules. In my opinion, enrolling with Medicare yourself online means that you may be bypassing the rules concerning the different periods during the year when one can enroll AND make changes.The only thing for you to do at this point is to enroll with a Medicare Advantage plan temporarily (you HAVE the right to do this at anytime since you've never enrolled before by picking up Medicare Part B with a monthly premium). Then, when the Open Enrollment begins on October 15th thru Dec. 7th (to become effective on Jan. 1st of the following year), you have what is known as "a trial right", meaning since you have your very 1st Medicare plan for less that 12 months, you will be able to apply for a Medigap (a.k.a., Med. Supp.) without having to answer any medical questions concerning pre-existing conditions.
Using any online information only yields the more well-known tenets of Medicare. The best advice I could ever give anyone regarding THE most important aspect of your life: HEALTH, is to be certain to get a 2nd & even 3rd opinion from an independent rep who is also known as a broker. However, in using a "Captive Agent": one who only has allegiance to one insurance firm, is foolhardy since all companies who offer Medicare-compliant Advantage plans can vary the rules to a certain extent. Though I truly hope that most agents are honest/reliable and can cover the gamut of the regulations, as an instructor myself, I will deliberately "over"-emphasize the more important areas/rules to all of my clients. Good luck and if needed, call 1-800-MEDICARE so that the person on the other end who's trained for this, confirms what a trial right means.
What is Guaranteed Issue for Medicare Supplement plans, and when does it apply?
When clients ask about Guaranteed Issue for Medicare Supplement plans, I explain it’s a right that stops insurers from denying coverage or raising rates due to pre-existing conditions. It applies during your initial enrollment at 65—starting the first day of your birthday month and lasting six months—or within 63 days of losing qualifying coverage, like an employer plan, or during your 12-month trial period if you’re new to Medicare Advantage and switch back to Original Medicare. For folks under 65 with disabilities, federal law doesn’t guarantee it, but many states offer a similar six-month window when you enroll in Part B. Missing these windows usually means facing medical underwriting.
How does Medigap Plan K compare to Plan G for someone on a tight budget?
Medigap Plan K differs from Medigap Plan G in the following ways: Plan K covers only 50% of coinsurance/copayment costs for benefits such as Part B cost share; blood; Part A hospice; skilled nursing; and Part A deductible. Plan K offers no coverage for costs such as Part B deductible; Part B excess charges; and foreign travel emergency. With an out of pocket limit of $7220 in 2025, careful consideration should be taken by an individual on a tight budget to ensure that the premium savings is worth the additional financial exposure. A standard High Deductible plan G or F may be a better alternative. For more information on your specific situation, please call me directly at 239.848.8893.
I applied for a Medigap plan and got denied because of my health history-how is that even legal when I've paid into Medicare for years?
Medicare and a Medicare supplement are 2 completely different things. Medicare is what you paid into. A Medicare supplement is from a private insurance company. They have underwriting questions that you have to be able to answer correctly or they can deny you. They are completely separate things. The supplement works with Medicare to pay what Medicare doesn't pay. Medicare is what you paid into all these years. A Medicare supplement is something you have to purchase. Different companies have different questions so depending on your health situation, you may or may not be able to by one. Hope this helps explain.Cleo Martin
803-730-8368
