What's Medicare supplement insurance coverage?

Who is this for?

If you're shopping for a Medicare plan for the first time or thinking of changing your current plan, this explains one of your options.

Medicare supplement insurance plans, sometimes called Medigap, have been around almost as long as Medicare. They're sold by health insurance companies like us. They help people pay for their share of the costs for health care services covered by Medicare. Those costs include:

  • A set amount called a deductible you pay before Medicare starts paying. Medicare has two deductibles: one for Part A, which covers hospital services, and one for Part B, which covers medical services.
  • Hospital expenses applied after you meet your Part A deductible. Medicare pays your expenses for the first 60 days you're in the hospital. Then you start paying $341 per day in 2019. That amount increases the longer you're in the hospital.
  • A portion of the cost of most services after you meet your Part B deductible. Medicare pays 80 percent of your costs. You pay the other 20 percent.

So your costs can really add up. That's where a Medicare supplement insurance plan can help. It'll pay your 20 percent coinsurance. It'll pay for your hospital expenses. Some supplement plans pay one or both of your deductibles. Some will pay for emergency care you need outside of the U.S.

How it works

Generally, before you can buy a supplement plan, you have to be at least 65 and enrolled in Original Medicare Part A and Part B.

You apply for a Medicare supplement plan offered by a health insurance company. These plans only cover one person, so if you and your spouse both want supplement coverage, you'll each need a plan. It doesn't have to be the same plan.

Budget basics

You'll have up to three monthly payments:

  • Your Medicare Part B premium. Most people have this taken out of their Social Security check.
  • Your Medicare supplement plan premium you pay to your health insurance company.
  • Supplement plans sold after 2006 don't include Part D prescription drug coverage. If you don't have drug coverage from another source that meets certain standards, you'll need a Part D plan. You'll likely have a premium for that too.

When you need care

With most Medicare supplement plans, you can go to any doctor or hospital that accepts Medicare. You'll give them your Medicare card and your supplement plan ID card.

Original Medicare will pay its share. Your supplement plan will pay your share of the costs, depending on what the plan covers. It may also coordinate payment with Medicare and your health care providers. That means you won't have to bother with claim filing or paperwork.

Your supplement plan choices

The government decides which supplement plans health insurance companies can offer. There are 10 different plans: A, B, C, D, F, G, K, L, M and N. Plan F also offers a high-deductible option. Each plan pays the same amount for the same services, no matter which health insurance company is selling it. There are two main differences:

  • Which plans a company offers. But all companies that sell Medicare supplement plans or Medigap plans have to offer Plan A.
  • What the company charges for their supplement plans.

Learn more about different Medicare supplement plans and see how they compare.

What's not covered

At one time, some Medicare supplement plans included prescription drug coverage. That ended in 2006. All plans sold after that year don't cover prescription drugs. A supplement plan with drug coverage you have from before 2006 might not meet current health care standards. You can enroll in a separate Part D plan, like a Prescription BlueSM PDP plan

Original Medicare covers some dental, vision and hearing services. Your Medicare supplement plan will pay your share of the cost in those cases. Medicare doesn't cover routine dental or vision care or hearing aids. These are not part of Medicare supplement plans either.

Important information about your plan

The Medicare deductibles, coinsurance and copays listed are based on the 2019 numbers approved by the Centers for Medicare and Medicaid Services. You can go to any hospital, doctor or other health care provider in the U.S. or its territories that accepts Medicare. You don't have to use our network. Blue Cross Blue Shield of Michigan administers Blue Cross Medicare Supplement plans. Where you live, your age, gender and whether you use tobacco may affect what you pay for your plan. Your health status may also affect what you pay. This is a solicitation of insurance. We may contact you about buying insurance. Blue Cross Medicare Supplement plans aren't connected with or endorsed by the U.S. government or the federal Medicare program.

If you're currently enrolled in Plan A or Plan C, you can stay with your plan as long as you pay your premium. You may enroll in Plan C if you’ve lost coverage under a group policy after becoming eligible for Medicare. You're also eligible if you had Plan C, then enrolled in a Medicare Advantage plan, and now would like to return to Plan C. You can do this as long as it’s within the first 12 months of your Medicare Advantage plan. You're automatically eligible for Plan A if you’re 65 or older. If you’re under age 65, you are eligible for Plan A if you’ve lost coverage under a group policy after becoming eligible for Medicare. You can also enroll if you had Plan A, then enrolled in a Medicare Advantage plan, and now would like to return to Plan A. You can do this as long as it’s within the first 12 months of your Medicare Advantage plan. You’ll need to meet these requirements to apply for these plans.