Two high-deductible Medicare Supplement policies, Plan F and Plan G work with Medicare to help with costs that Medicare doesn’t pay. Generally, with a high-deductible Medigap policy, you’ll pay more out of pocket before it begins to provide coverage. The content below discusses everything about Medicare Supplement high-deductible plans.
How does a high-deductible plan work with Medicare?
You’ll need Original Medicare coverage to qualify for a high-deductible Medigap plan. Medicare Part A and Part B pay a portion of the Medicare-approved amount; a Medigap policy can help pay the remaining coinsurances or deductibles. Some Medigap plans can help with the cost of Part B excess charges, foreign travel emergencies, Skilled Nursing Facility care, hospice care, and more.
With a high-deductible Medigap policy, the insurance company won’t pay until you reach the deductible. The deductible amount in is $2,740.
Many Medicare beneficiaries never come close to reaching the deductible since Medicare covers the total cost of most preventive services. Of course, prices can be significant if admitted to the hospital.
The inpatient Medicare Part A deductible is $1,632 per benefit period, meaning you can pay quite a bit upfront. The plan pays the remaining qualifying expenses once you reach the $2,740 in out-of-pocket spending on eligible healthcare services.
If you’re considering this type of policy to save money monthly, having the funds available for costly hospitalization is essential.
Does Medicare pay anything before the deductible?
Before you meet the deductibles, preventive health care costs have full Medicare coverage. Also, the Medicare program will continue to cover its portion of your healthcare costs. The Medigap plan will be the policy that doesn’t pay until you meet their deductible.
So, even though you sign up for a Medigap plan, you still have your Medicare benefits. The private Medigap health insurance is a separate policy that works alongside your Medicare.
The deductibles and coinsurances you pay Medicare count towards the high deductible policy until you reach your limit. Then, the Medigap policy pays for covered services in full.
Which high-deductible Medigap plans are available?
Both Medigap Plan F and Plan G offer a high-deductible version. High-deductible Plan F is not available to beneficiaries eligible for Medicare after 2020. However, anyone can sign up for High-deductible Plan G.
The best time to enroll in a Medigap plan is during the Open Enrollment Period. There is no medical underwriting during this time since you’re eligible for a guaranteed issue.
Beneficiaries in Massachusetts, Minnesota, and Wisconsin have different policy options available. Massachusetts’ Medigap offerings don’t include high-deductible options, while you can choose a high-deductible Medigap plan in Minnesota. Wisconsin Medigap plan options also include a high-deductible option.
What are Medicare high-deductible Plan G’s pros and cons?
The low monthly premium is the most significant benefit of any high-deductible health plan. Beneficiaries expecting only to need preventive care can save a lot of money.
Also, the benefits once you meet the deductible are equal to standard plan G’s.
A con to the High-deductible Plan G is paying the outpatient Medicare Part B deductible. Also, the insurance benefits don’t kick in until after you’ve met your annual deductibles.
These deductibles reset each year. Also, you’ll pay the Part B coinsurances until you meet the deductible. Then, the deductible resets every calendar year, usually at a higher amount.
What are Medicare high-deductible Plan F’s pros and cons?
As with any high deductible option, the lower premium is the most significant benefit. Once you meet the deductible, the benefits are the same as standard Plan F.
The most significant downside, if health issues become severe, medical costs can pile up. Also, the deductible can change yearly, making it hard to predict future medical expenses.
What are alternatives to Medigap high-deductible plans?
Medicare Supplement Plan K and Plan L could be another Medigap option for saving money on monthly premiums. These plans have a cost-sharing benefit and out-of-pocket limits.
If you want more coverage than those two options, a Plan N may be beneficial. Plan N has a slightly lower premium than standard plan G or Plan F in exchange for a few copays.
Another option would be a Medicare Advantage plan since the premiums are low. However, a Part C plan could be more expensive in the long run since there are ongoing out-of-pocket costs through coinsurances and copayments.
Lower-income beneficiaries may be eligible for assistance such as:
Military veterans may qualify for Veterans Administration Health benefits.
FAQ’s
Is a High-Deductible Medicare Plan Worth it?
Medicare beneficiaries wanting to save on monthly premium costs may want to consider a high-deductible Medicare Supplement policy. Whether or not this plan type is beneficial long-term depends on your health, longevity, and other unpredictable things. But all Medigap plan reviews have A+ ratings.
What is the downside of a high-deductible Medicare plan?
While high-deductible plans have a low premium and cover preventive care, an emergency could lead to immense out-of-pocket costs. However, once you reach the deductible, your Medigap coverage helps pay its portion of Medicare-covered expenses.
Why do people choose high-deductible plans?
Medicare beneficiaries choose high-deductible Medigap plans because they offer a lower premium. These plans make sense for those who don’t plan on incurring high medical expenses in the coming years or those comfortable paying the deductible if an emergency occurs.
How to sign up for a high deductible Medicare Supplement plan
We can help you determine the best policy for your needs, whether that’s a high-deductible plan or something else. We’re here to help you compare your options and get the best deal for your situation.
Call us now at the number above to make sense of your Medicare and find the right plan. Or, fill out our online rate form to compare your rates today!
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