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Medigap Options and Future Changes

October 29, 2018

Medigap insurance plans are additional private insurance options on top of Medicare that cover health care costs that Medicare Part A and B do not cover such as deductibles, coinsurance for some services, and various copayments. Medigap policies are bought by individuals who either do not have an employer/union supplied Medicare supplement plan or do not qualify for Medicaid.

Medigap plans come in different categories classified by letter from Plan A through Plan N. However, Plans E, H, I, and J are no longer open to new enrollees.

The current most popular plan that accounts for approximately half of all enrolled Medigap plans is Plan F. Plan F policies eliminate the additional out-of-pocket expenses associated with Medicare Part A and Part B. Premiums under Part F may be higher than other Medigap plans, but individuals with Part F appreciate being able to budget only their monthly premium for their health care costs.

The major upcoming change to Part F is that as of 2020, Part F plans can no longer enroll new applicants. Current Plan F enrollees and those who enroll before 2020 will still be able to stay in their Part F plans after 2020. However, the monthly premiums for Part F may rise significantly in the long-term as the current pool of Part F policy holders ages and faces higher health care costs without being aided by younger enrollees with lower health care costs.

One substantially similar alternative that will continue to accept new enrollees is Plan G. Plan G covers everything that Plan F covers except for the Medicare Part B deductible. In 2017, the Part B deductible is $183.

Another increasingly popular plan that balances lower premiums with modest additional out of pocket expenses is Plan N. The out of pocket expenses under Plan N are the Part B deductible, copayments of up to $20 for doctor visits, copayments of up to $50 for non-admission hospital visits, and Part B excess charges.

Part B excess charges are the option that health care providers can charge individuals up to 15% above what the Medicare reimbursement is for any given procedure. Individuals should ask their health care providers about whether or not their care would involve potential excess charges and seek out providers whose care either does not involve or minimizes excess charges.

One additional, relatively minor plan that will also stop accepting new enrollees in 2020 is Plan C. Plan C is identical to Plan F, except that Plan C does not cover Part B excess charges.

To discuss your Medicare, Medigap, and Medicaid options, please call Martha C. Brown & Associates at (314) 962-0186.

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Martha C. Brown & Associates, LLC assist clients with Estate Planning, Elder Law and Probate in St. Louis City, St. Louis County, St. Charles County, Jefferson County, Franklin County and the surrounding areas including Arnold, Ballwin, Barnhart, Bellefontaine Neighbors, Black Jack, Bonne Terre, Brentwood, Bridgeton, Cedar Hill, Chesterfield, Clayton, Crestwood, Creve Coeur, Crystal City, Des Peres, DeSoto, Ellisville, Farmington, Fenton, Festus, Ferguson, Florissant, Fredericktown, Frontenac, Hazelwood, Herculaneum, High Ridge, Hillsboro, House Springs, Imperial, Kirkwood, Ladue, Lake St. Louis, Manchester, Maplewood, Maryland Heights, Mehlville, Normandy, O'Fallon, Olivette, Pacific, Pevely, Richmond Heights, St. Ann, St. Charles, St. Clair, St. Peters, Ste. Genevieve, Sunset Hills, Town & Country, University City, Union, Valley Park, Washington, Webster Groves, Wentzville , Wildwood.