Medicare Questions & Answers: Medicare Supplement
Medicare Supplement Q&A
Showing 29 questions
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.
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.
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.
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. As long as the facility where you have the surgery accepts Medicare assignment, you will only be responsible for the Part B annual deductible ($257 for 2025). Once you pay the Part B annual deductible, Medicare will pick up 80% of the remaining bill, and your Medigap Plan G will pick up the other 20%. https://medicareagentshub.com/#
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
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.
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.
Is paying for a high-end Medicare Supplement plan really worth it, or is it overkill?
The answer depends on your specific situation. In general, Medicare pays for approximately 80% of your medical expenses, not including deductibles. The high-end Medicare Supplement plans pick up nearly all of the remaining 20% (in the case of the Plan G, you pay one small deductible.) Depending on the procedures or extent of care, this could still be a large financial liability. So, each person must decide if the premium for these plans is worth the potential risk of incurring even this portion of any medical bills. For many of my clients, paying this premium gives them the peace of mind that those bills will be covered, if and when they need them, even if they don't need a lot of care at this time. To balance out this premium cost, Medicare Supplement plans give you the freedom to go to any Medicare provider in the whole nation. If you reside in a different state for several months out of the year, Medicare Supplement plans suite well. The flexibility and peace of mind of Medicare Supplement plans may be worth the premium cost.
I went with Medigap because I travel a lot, but now I'm paying a fortune in premiums. Did I make a mistake?
You can can change to a Medicare advantage plan during Annual Enrollment. The premium is $0 but you will have copays and a book or doctors.
My neighbor says I'm crazy for paying for a Medigap plan when Medicare Advantage is "free." What should I tell him?
Medicare Advantage Plans are not FREE. They may have a $0 premium. However, you must continue to pay your Medicare part B premium to qualify for a Medicare Advantage Plan.
What's the best way to compare my current Medicare supplement plan to a Medicare advantage plan?
The best way to compare is to find an independent broker that you trust and whom others trust. Being fully independent allows us to show you most (or all) of the plans in your area and also to compare your current plan to a Medicare Advantage plan. They are very different plans with unique nuances and having a broker that doesn’t cost you anything is a smart way to shop!
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
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.
What's your go-to strategy for helping someone decide between Medicare Advantage and Medigap?
To help someone choose between Medicare Advantage and Medigap, I ask:Health Usage: Frequent doctor visits or chronic conditions? → Medigap.
Budget: Want low monthly premiums? → Medicare Advantage. Prefer predictable costs? → Medigap.
Doctor Choice & Travel: Want nationwide coverage and keep any doctor? → Medigap. Okay with networks? → Medicare Advantage.
Drug Coverage: Want it included? → Medicare Advantage. Don’t mind a separate plan? → Medigap.
Simplicity: Want one bundled plan? → Medicare Advantage. Don’t mind piecing it together? → Medigap.
It's important to have a conversation going over all of this and find out what fits best for each individual. There are lots of plans out there with different benefits. Not all may fit your needs.
Are Medicare Supplement plans the same thing as "Medicare Secondary Insurance"?
Yes. Medicare supplement plans are often referred to as Medigap plans. These plans work in conjunction with your traditional Medicare, but do not take the place of traditional Medicare, as Medicare Advantage plans do.
I have Original Medicare, a Medigap Plan G, and a Part D plan, but I'm still facing high costs for my specialty medication. What options exist for someone in my situation?
Make sure that your Part D plan has the best possible coverage for your specialty medication. All plans are different and some will cover your specialty meds better than others.
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?
No, you will simply be re-calculated at the Florida rate. You may however, want to look at the Medicare Advantage plans in Florida as they are some of the most cost effective Medicare Advantage plans in the nation.
Can I get a Medigap plan with Guaranteed Issue if I'm losing my employer coverage?
You will be considered “guaranteed issue” as long as your employer coverage is considered credible coverage, which in most cases it is. There are a few other instances where you can be considered guaranteed issue.What is Guaranteed Issue for Medicare Supplement plans, and when does it apply?
Guaranteed issues for Medicare supplement plans ensure you can purchase a Medicare supplement/Medigap plan that picks up the gaps that Medicare Part A and B leave behind. A guaranteed issue means you do not have to be questioned about your health conditions with the insurance underwriters, and the policy will not be denied. Guaranteed issue applies to the six months around your 65th birthday. Three months before your 65th birthday, the month of your 65th birthday, and three months after your 65th birthday, you have the right to get a guaranteed issue policy for your Medigap plans. After that, there are some special guarantee issues when retiring from a group insurance plan, but that would be for another discussion.
What states have the Medigap "birthday rule" and what is it?
As of July 2025, there will be ten states that will have a "birthday rule" where existing owners of Medigap plans can change plans or change Medigap companies without underwriting. The ten states with the "birthday rule" are, California, Idaho, Illinois, Maryland, Oregon, Nevada, Louisiana, Kentucky, Utah, and Virginia.
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.
If you’ve got Medigap Plan C, that’s actually one of the more solid plans. Since it works alongside Original Medicare, most of the time your bloodwork, if it’s medically necessary and ordered by your doctor should be covered by Medicare Part B, and then Plan C usually picks up the leftover costs like the deductible and coinsurance. So chances are, you’re not paying much, if anything. But it’s always good to double-check with your provider just in case something’s considered non-routine.
In your experience, what are the best Medicare Supplement insurance companies and why?
The best Medicare Supplement companies varies from region to region, even the large ones are not everywhere, so it makes no sense to compare and contrast by name , rather the best choice is the one that strikes a balance between cost, coverage and added values.
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.
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.Browse Other Questions & Answers
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