Health Insurance can be complicated, even after you retire. In fact, over 50 percent of seniors report that they find the Medicare process confusing. So let’s start with the basics.
At age 65 you are eligible to enroll in Original Medicare. This has two parts: Medicare Part A (which covers hospital and in-patient care) and Part B (which covers outpatient care, doctor services, preventative care, and medical equipment). But what can you do about the expenses you may incur that are not covered by Medicare?
There are a variety of options that you can explore to supplement your healthcare and keep costs down. Like other kinds of insurance, supplemental medical plans come in many shapes and forms, and there are a number of private health insurance companies, like Aetna, that offer them.
Who Is Aetna?
Aetna is a healthcare company first founded in Hartford, Connecticut in 1853 as the Aetna Insurance Company. In 2018, it was acquired by CVS Health Corporation. Today, Aetna provides a variety of healthcare services and tools for individuals, employers, and those working in the healthcare field. This includes medical and dental insurance plans, Medicare and Medicaid services, and medical management help for an estimated 39 million people both in the United States and internationally.
What Is a Medicare Supplement Plan?
Original Medicare (Parts A and B) covers many health-related costs for those 65 and older, but there are some expenses that are not covered with Original Medicare enrollment. For these “gaps”, there is a range of Medicare Supplement Insurance (Medigap) plans offered by private insurers to help you avoid paying out-of-pocket at the doctor’s office. Medigap plans also come with the freedom to see any doctor that accepts Medicare, and they can allow you to see a specialist without a referral.
What Does Medigap Cover?
Medigap helps you pay for expenses not covered by Medicare Part A, including deductibles and in-patient costs. This includes help with costs of hospital stays longer than 60-days not completely covered by Medicare Part A. It also covers doctor bills related to Medicare Part B services. By paying an up-front premium for a Medigap plan, you can avoid larger bills that you may incur if you end up needing a long-term, in-patient hospital stay or frequent specialist visits. Medigap plans are regulated by Medicare and, in the same way, are identified by letters of the alphabet. The specific costs of these plans differ depending on coverage.
What Does Medigap Not Cover?
A Medigap plan can help you with many expected and unexpected healthcare costs, but it doesn’t cover every gap in your insurance. For instance, Medigap plans will generally not cover long-term care, such as costs incurred at nursing home facilities. It also does not cover Dental Insurance. Dental policies can be purchased separately, and some dental insurance policies include vision insurance, which is also not included in Medigap plans. Eyeglasses and hearing aids are not covered, nor are costs associated with private nursing services. Prescription drug costs are covered under Medicare Part D and are thus not included in Medigap plans.
FYI: Medigap policies are standardized throughout different insurance providers. The main differentiating factor is where you live, so you should be sure to check out some different options.
Medicare Supplement Plan Features
- Plan A – Part A of Original Medicare covers the costs of hospital stays for up to 60 days. Medigap Plan A covers the cost for up to 365 days after the initial Medicare Part A coverage ends. It also covers Medicare Part B co-pays and Part A hospice co-pays.
- Plan B – In addition to the benefits of Medigap Plan A, Plan B also covers the cost of your Medicare Part A deductible.
- Plan C – This Plan covers everything offered in Medigap Plans A & B, and also covers the Medicare Part B deductible. In addition, it covers skilled-nursing service co-pays and up to 80% of medical costs incurred while you are abroad.
- Plan D – Medigap Plan D covers everything offered by Plan C except the Medicare Part B deductible (this is not covered under Plan D).
- Plan F – This Plan covers everything offered by Medigap Plan C, and also covers Medicare Part B excess charges (costs healthcare providers are legally able to charge that are more than the amount Medicare approves).
- Plan G – Medigap Plan G covers everything offered by Plan F except the Medicare Part B deductible (this is not covered under Plan D).
- Plan K – Medigap Plan K covers the cost of hospital stays for up to 365 days after the initial Medicare Part A coverage ends. It also covers up to 50 percent of Medicare Part B copays, Medicare Part A hospice care co-pays, skilled-nursing service co-pays, and the Medicare Part A deductible.
- Plan L – This Plan is very similar to Medigap Plan K. It covers the Medicare Part A hospital costs up to 365 days after the initial coverage ends. In addition, it covers up to 75 percent of Medicare Part B copays, Medicare Part A hospice care co-pays, skilled-nursing service co-pays, and the Medicare Part A deductible.
- Plan M – Medigap Plan M covers everything included in Medigap Plan D except that it only covers 50 percent of the Medicare Part A deductible.
- Plan N – Medigap Plan N covers everything included in Medigap Plan D, except some visits to doctor’s offices and emergency rooms that may result in up to $20 (regular office) or $50 (emergency) co-pays.
FYI: Some Medigap Plans include coverage, or partial coverage, for doctor and hospital costs incurred for the many seniors who travel abroad. As you explore your options, be sure to keep in mind the kinds of coverage that best suit your lifestyle.
Aetna Medicare Supplement Plans
Which Medigap Plan Is Right for You?
Through Aetna, all Medicare-eligible applicants can apply for Medigap Plans A, B, D, G, and N. Anyone that was eligible for Medicare before the year 2020 can also apply for Medigap Plans C and F.
- Aetna’s Medigap Plans A and B: These are the most basic Medigap Plans offered by Aetna. These plans do not cover skilled nursing facility coinsurance, Medicare Part B deductibles, or Medicare Part B excess charges, which can add up. They also do not cover medical emergencies that may happen in foreign countries.
- Aetna’s Medigap Plans C, D, and N: These plans offer everything that is covered by Medigap Plans A and B, with additional supplemental coverage. While the premiums for these plans are higher, the added coverage helps keep out-of-pocket costs down. (Plan N does require a $20 co-pay for office visits and a $50 co-pay for emergency room visits.)
- Aetna’s Medigap Plans G and F: Medigap Plans G and F cover Medicare Part B excess charges in addition to the coverage offered by Aetna’s other Medigap plans. They also offer a high-deductible Medigap Plan G and Plan F, which provide the same benefits once the calendar-year deductible has been met.
How To Enroll in an Aetna Medigap Plan
To apply for an Aetna Medigap Plan, you must be at least 65 years old, already have Medicare Parts A and B, and you must be continuing to pay your Part B premium. I was able to go to the Aetna website and review options for Medigap Plans. This started with selecting the state for the individual looking for supplemental care. After entering this information, I was directed to a page that allowed me to ask for a quote. The next page asked for the state of residence, zip code, date of birth, gender, and date when coverage was needed for the person applying.
After providing this information, Aetna took me to an easy-to-read list of available Medigap plans. This list was broken down by plan type and included information about monthly premiums, benefits, and possible discounts. The Aetna website provides a phone number where a licensed insurance agent can be reached to complete the enrollment process. These agents are available Monday through Friday from 8:00 AM to 8:00 PM. It is also possible through Aetna’s website to request additional information through email or request that an agent call you.
Please note, that the costs of your Aetna Medigap Plan will vary depending upon the specific plan and your location in the United States.
Aetna Health App
In addition to an interactive website, Aetna also offers a smartphone app. The Aetna Health App is available for iPhone through the App Store and for Android through Google Play. For the 42 percent of seniors who own a smartphone, this app can be a great way to keep track of your Medigap benefits.
Users can view their Medical ID cards, see the benefits of their plan, and monitor the progress they have made toward their deductibles. The app also allows you to view and manage claims you have filed through Aetna and see your account balances. Using Aetna Health, you can find a doctor in your network, compare cost estimates for procedures, and get cost estimates on medications. It even provides personalized recommendations for users to improve their overall health.
FYI: The Aetna Health App for iPhone stores your Medical ID Card in your Apple Wallet for easy access.
Alternatives to Aetna Medigap Plans
If Aetna doesn’t seem right for you, you can explore a number of other insurance companies. Some popular options are summarized below.
- Cigna: Cigna is widely popular, both in the United States and abroad. They offer Plans A, F, High Deductible F, G, and N. Cigna offers savings on a range of programs, and there are discounts available for household enrollments. Except for non-payment of fees or information misrepresentation, Cigna policies are guaranteed renewable for life.
- State Farm: State Farm Medicare Supplement Insurance offers Plans A, C, D, F, G, and N. State Farm also offers a wide variety of other insurance policies, including car insurance, home insurance, and life insurance. State Farm allows policy-holders to bundle their different policies together and save.
- Mutual of Omaha: Mutual of Omaha offers banking, financial, and insurance services. They offer plans that include a range of coverage and deductible options. These include Plans A, F, G, High Deductible G, and N. Plans are guaranteed as long as premiums are met.
- AARP: AARP is a nationally-trusted organization focused on helping seniors in a variety of ways, including providing Medigap Insurance through United Healthcare. AARP offers Plans A, B, C, F, G, and N; and they also offer Plans L and K (not offered by some other insurers). They have an easy-to-use website that includes tools like drug-cost estimators.
Healthcare can be tricky, even with a national system in place for those over the age of 65. Medicare Supplement Plans can provide peace of mind for services not covered by Medicare Part A and Part B. There are a variety of private health insurance companies that offer these Medigap Plans, including Aetna. Based on your lifestyle and your needs, you can choose the coverage and premiums that work best for you.
Frequently Asked Questions
- Does Aetna have a Medigap plan?
Currently, Aetna offers Medigap plans A, B, C, D, F, high-deductible F, G, high-deductible G, and N in the majority of the United States. Each of these Medigap plans covers coinsurance or copays (if not both) for Part A and Part B services.
- Are Medicare Advantage Plans the same as and Medicare Supplement (Medigap) Plans?
Aetna offers Medicare Advantage Plans, but these are not the same as Medigap Plans. Medicare Advantage Plans are alternatives to Medicare Part A and B and come with a variety of options. They are separate from the Medigap Plans explored in this article.
- When is the best time to enroll in a Medigap Plan?
There is a six-month enrollment period that starts on the first day of the month you turn 65 years old. As long as you have signed up for Medicare Part B, you are eligible for Aetna’s Medigap plans. You can still apply for these plans after that window has closed, but your application may be denied based on questions about your medical history. During the enrollment period, these questions will not affect your eligibility.