Medicare Questions & Answers: Medicare Supplement
Medicare Supplement Q&A
Showing 18 questions
Do I have to answer health questions when switching from one Supplemental/Medigap plan to another?
It depends. There are a lot of factors to consider here, such as the State you reside in, how long you have had your current Medigap policy, and the timeline of when you plan to switch.Unfortunately there are a lot of rules when it comes to Medicare Supplement policies. That’s why it’s important to work with a knowledgeable, trustworthy and licensed professional.
Can I change my Supplemental/Medigap plan at any time?
Yes, you can change your Medigap plan anytime, but depending on your state, you might have to go through medical underwriting.California has a birthday rule, which gives you 60 days after your birthday each year to switch to a plan with equal or lesser benefits—no health questions asked.
New York lets you switch anytime with no underwriting, so you’re always guaranteed coverage.
If you’re in another state, you might need to go through underwriting unless you qualify for a special exception. Always good to check before making a switch!
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?
Yes, you can switch from a Medicare Advantage plan to Original Medicare and subsequently enroll in a Supplemental/Medigap plan during the Annual Enrollment Period (AEP) without needing to answer health questions, as long as you disenroll from the Advantage plan and return to Original Medicare within the first 12 months of your Advantage plan enrollment
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.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’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?
Yes. After meeting your deductible your Medicare Supplement plan G would cover what Original Medicare doesn't cover
How does Medigap Plan K compare to Plan G for someone on a tight budget?
Medicare G is the most comprehensive and most expensive. Plan K is less expensive but has a higher max out of pocket. Ideal for someone in good health and able to pay out of pocket.
What’s the financial risk of sticking with Original Medicare without a Medigap plan?
I have a client who if she had went with her first choice of a Medigap plan her annual cost would be around $2,400. She decided to take a less expensive route and enrolled in a Medicare Advantage plan. She was diagnosed with a health issue requiring a doctor to administer shots in her eye every quarter for the remainder of her life. This cost is reaching her out of pocket maximum of $5,500 which is more than twice the annual cost of her supplement. In this particular case it would have been more cost effective for her to have been on the Medigap plan costing her $2,400 per year.
How do I know if a Medigap policy is right for me, and what's the best time to buy one?
This question cannot be answered without knowing all your circumstances, but there are just as many different answers to this question as there are agents in the field, as to why you should or should not. Again, a trustworthy agent can explain this in detail.
If Medicare Supplement (Medigap) plans are better for long-term coverage, why don’t more people choose them?
Advertising often misleads people to assume they know things they don't. The privatized companies that offer MA plans televise 9500 commercials per day! Have you seen many, if any, commercials regarding supplement plans? So many people don't have the information about them and the difference they make. In today's world, many seniors fear that they will be "Taken for a ride", so trusting a company or an agent is difficult.MA companies make it seem so easy! They lay out the positives, but don't show what is missing from the policies, such as the choice of practitioners, specialists, or travel benefits. It doesn't show that the highest quality choices very often do not accept the MA product. It doesn't show what Out-of-Pocket costs are if you do not choose a Network Provider. It doesn't clarify that in giving your Original Medicare back for the MA plan that you lose coverage for your Durable Medical Equipment needs. Those plans need to be changed every year, and the policy you have today may not be in place next year, or your Doctor may not even participate in that plan any longer. You rarely have that issue with Medigap plans.
And we cannot leave out that the premiums for the Medigap plans may be out of reach for some. Unfortunately, some find out too late that they chose "Easy" instead of "Thorough", and what they saved in premiums cost them hugely later on when they needed more quality coverage.
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’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?
If you have a Medigap plan F there would be no copayment for emergency room visit, but if you are travelling internationally that is a different story. Plans provide 80% to a lifetime maximum of $50,000 in coverage after the first $250 deductible each calendar year
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.
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 went with Medigap because I travel a lot, but now I’m paying a fortune in premiums. Did I make a mistake?
No, that’s a great idea but if you are healthy, it’s time to see if you can get more cost effective coverage.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.
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.
The bloodwork is included in your Medigap plan C under the Part B benefits.The plan C covers 100% of your Part B coinsurance or copayment.