Retirement Plans

How To Understand The Various Medigap Plans On The Market

Medigap plans were all standardized and placed into 12 distinct plans and labeled A through L. It is important to understand that Medigap is not a function of the United States government and is privately owned. A number of private businesses own and operate it and offer it as a number of benefits.

Read More Here

However, Medigap added 2 new plans to its organization known as M and N. Additionally, insurers have decided to no longer offer plans E, H, I and J. If you had used any of those policy plans you would have been renewed without any type of change in your policy.

However, the newer policies such as M and N offer extra cost-sharing with a reduction in the premium.

In many cases, the M and N plans are quite similar to Medigap plan F. However, it is important to realize that M will only cover 50% of the $1,100 deductible that is needed for Medicare part A, but you should read more here. Whereas the Part B of the $155 will not be covered by either the M or N plan.

Additionally, plan M will not cover any part of the “excessive charges” that was included in Part B. Excessive charges would help to cover any additional cost that your physician would charge over what was included by Medicares acceptance.

In contrast, plan N will fully cover all of the Part A $1,100 deductible. However, there is a co-payment of $20 for a physician visit. A visit to the hospital will require a $50 co-payment. Additionally, there are a number of private insurance companies that sell more of N than M. Plan N will generally cost about 35% less than what was known as plan F.

If you are considering changing plans in the near future, it is best to compare the overall premium savings to what you will be paying out of pocket. While plan N is less expensive than what you were enrolled in, you will be required to pay the $155 co-payment for Part B.

Take the time to fully understand all of the required co-payments and calculate how often you need to see your physician or generally visit the emergency room. Will your overall costs be lower with N? Also understand that while the excessive charges of Part B are covered under plan F, they will not be covered under M and N. This is essential to understand as the vast majority of physicians will charge more than what Medicare will typically pay.

If this is the first time you have signed up for part B Medicare, you may be able to qualify for any of the plans regardless of your overall health condition. However, if you are unable to sign up during the open-enrollment period, you may be rejected for health concerns. There are several insurers who will still sell you M or N regardless of your health situation, especially if you were already enrolled in E,H,I or J Medigap plans.