Medicare Supplement Plans, also known as Medigap policies, are an important piece of health insurance coverage for many Americans. These policies cover some of the “gaps” that Original Medicare doesn’t cover, such as copays and deductibles.
But Medigap plans vary widely, and there is a range of premiums and coverage options out there. If your financial or medical situation changes, you may find that the Medigap plan you’re covered by is no longer the best choice for you. You might be able to save money or get more extensive coverage on a different plan. But how can you switch your Medigap policy?
In this article, we’ll look at the differences between some common Medicare Supplement Plans, and when and how you can switch between them.
MEDICARE SUPPLEMENT PLANS
Medicare Supplement Plans are a way to add more comprehensive coverage to your Original Medicare policy. If you have Medicare Parts A & B, then you’ll have to pay out-of-pocket costs, including copays, an annual deductible, and 20% coinsurance for many services.
Depending on which Medigap policy you choose, you can have some of those costs covered, as well as additional coverage, such as emergency expenses when you travel overseas.
Medigap plans don’t cover vision or dental care, or long term care. For that, you can look into a Medicare Advantage plan instead, although you can only have one or the other. If you take any prescription drugs, you can get a stand-alone prescription drug plan (Medicare Part D).
Medigap plans are standardized in most states, which means you’ll get the same coverage no matter which insurer you choose. Let’s look at 3 popular Medigap options.
If you have Original Medicare, then you’ll be covered for hospital care (Part A) and outpatient care (Part B). But your coverage only kicks in once you’ve paid your annual deductible. For Part B, that’s $185 per year, and for Part A, it’s $1,364.
Plan N covers your Part A deductible, as well as the “gap fee” that applies to hospital stays of longer than 60 days. It doesn’t cover your Part B deductible, but it does cover any other Part B expenses that Original Medicare doesn’t cover (except for excess charges).
You’ll have to pay a $50 copay for emergency room visits and $20 for office visits. You’ll also have to pay your Part B premium ($135.50) and Part A premium if you have one.
Part N plans don’t cover every expense, but because they cover most of your out-of-pocket expenses, they’re typically a good value for your money. You can expect to pay anywhere from $100-150 per month depending on your age, health status, and state of residence.
Medigap Plan G costs a little bit more than Plan N but offers slightly better coverage. The major difference is that it covers the excess charges that your doctor may charge above and beyond the costs approved by Medicare, which Plan N does not.
As with Plan N, Plan G covers your Part A deductible, and the gap fee for long-term hospital stays. You’ll be covered for most of the costs associated with nursing home and hospice care, as well as the first 3 pints of blood (Original Medicare covers additional pints).
There’s no copay for visits to the doctor or emergency room, so this plan may be a better option for patients who need frequent doctor’s visits. However, the monthly premium will be higher and may be as much as $300 in some states.
A third option is Medigap Plan F. This plan is being discontinued for new people as of January 1, 2020, but if you’re currently enrolled, or enroll in it before then, you’ll be able to keep it.
The major difference between this plan and Plan G is that it covers the annual deductible for Part B ($185). It’s one of the most popular Medigap plans because it offers the most comprehensive coverage, but you can expect it to cost more than other Medigap plans.
Other policies include Plan K, which covers 50% of most copays and coinsurance costs, and Plan L, which covers 75%. Since these plans offer less coverage, you can expect the monthly premium to be cheaper than for Plans F & G.
WHY YOU MIGHT WANT TO CHANGE PLANS
There are several reasons why you might want to switch to a different Medigap policy. First, you may not need all of the coverage your plan offers.
For example, Plan G covers excess costs and Plan N does not. But if your doctor or health care provider doesn’t charge excess costs, then that benefit won’t apply to you. You could switch to Plan N and pay a lower premium.
Another reason you might want to switch is that your health status may have changed and you need more comprehensive coverage than you did before.
For example, Plan G covers the copay for emergency room and doctor’s visits, while Plan N does not. If you’ve started seeing the doctor more frequently due to a change in your health care needs, then those copays can start to add up. Plan G may have a higher monthly premium, but you may save money by paying less in copays and excess charges.
A third reason may be that your financial situation has changed. Maybe you can afford a more comprehensive plan, or you want to look for a plan with a lower premium.
While each plan offers the same standardized coverage no matter which insurer you choose, the monthly premium can vary from insurer to insurer. You may be able to get the same policy from a different insurer at a better price.
Finally, you may be moving to another state. You don’t have to change policies when you move, since you’ll be covered anywhere that Medicare is accepted. But premiums can vary widely between states, so you may get a better price in your new location. Three states — Wisconsin, Massachusetts, and Minnesota — have their own standardized Medigap policies.
WHEN CAN YOU CHANGE MEDICARE SUPPLEMENTS?
Unfortunately, changing your Medigap policy can be a little complicated. If you want to change your policy after your initial enrollment period, then you’ll be subject to medical underwriting, and can be turned down or charged a higher premium based on your health status.
The only time you have a guaranteed issue right to Medigap – which means you can’t be turned down due to pre-existing conditions – is during the first six months after you turn 65 and enroll in Original Medicare, and during certain other specific circumstances.
For example, you may be able to enroll in Medigap if you’ve lost Medicare Advantage coverage due to moving out of state or a change in your insurer’s coverage area. You can also switch to Medigap if you’re unhappy with your Medicare Advantage plan within the first 12 months.
Otherwise, you’ll be subject to medical underwriting. So while you can switch policies at any time, it’s best to find a policy you like and stick with it to avoid any complications.
FREE LOOK PERIODS
There is one option for switching policies that can help you avoid any gaps in coverage. You’re entitled to a 30-day “free look” period during which you can try out a new plan.
This 30-day period isn’t technically free since you’ll have to pay the premium for both your old and new plan. But if you cancel your current plan before applying for a new one, then you might find yourself turned down by a new insurer and unable to go back to your old one.
The 30-day period gives you the chance to compare both plans and see which one is a better fit for you. Before the month is up, you can either cancel the new plan and keep the old one, or give up the old plan and accept the new one.
Use this time period to see whether the new plan is an improvement and whether it will make a difference to your monthly expenses and coverage options. You can’t keep both policies once the 30-day period is up, so you’ll have to choose one or the other.
HOW TO CHANGE MEDICARE SUPPLEMENTS
If you’re ready to change your Medicare supplement policy, you can search for a new plan using the Medicare Plan Finder. Once you find a plan you like, call up your new insurer directly to find out what options you have and to let them know you want to apply for a new plan.
If the new insurer approves your application, compare the premium and benefits to your current plan and decide whether or not it will save you money or offer the coverage you need. You have 30 days to try out the coverage before making a decision.
If you decide to keep the new plan, then call up your current insurer and cancel your coverage.
Changing your Medigap policy can be a big decision since you can’t go back to your old policy after the 30-day free look period is up. If you’re unsure whether you should switch plans or need help deciding which one is right for you, reach out to the team at The Medicare Store.
Our licensed insurance agents can answer your questions and help you explore your options of Medicare in Nevada. Just fill out the contact form to schedule a free phone consultation or in-person visit.