Many people look forward to turning 65 because it means finally receiving the Social Security and Medicare benefits they've paid into for most of their lives. What they don't expect is the need for a supplemental insurance to bridge the gap between actual healthcare costs and the costs Original Medicare covers. Mutual of Omaha Medigap plans fill that gap through a variety of Medicare supplement insurance plans.
What Medigap Insurance Is and Isn't
Medigap insurance is sold by private companies like Mutual of Omaha. The goal is to lower out-of-pocket expenses for the insured. Medigap plans, which are also called Medicare Supplement insurance plans, are separate insurance policies that you purchase to use in addition to your Original Medicare benefits. Private companies that sell Medigap coverage are required to follow strict laws and regulations.
Medigap insurance policies are not a replacement for Original Medicare. To qualify for a Medigap plan, you must be enrolled in both Part A and Part B of Original Medicare. You cannot enroll in a Medigap plan if you are enrolled in a Medicare Advantage Plan. Here is brief explanation of the differences between Original Medicare, Medigap/Medicare supplement and Medicare Advantage:
- Original Medicare is the healthcare benefit you receive from the government upon turning 65 years of age.
- Medigap/Medicare Supplement Insurance is private insurance you buy to pay medical costs not covered by Original Medicare.
- Medicare Advantage, called Part C, is private insurance you buy to take the place of Original Medicare Parts A and B coverage.
Medigap plans are standardized, which means every company that sells Medicare supplement insurance has to offer the same basic benefits. These benefits include coverage of coinsurances, copays and deductibles not covered by Original Medicare.
What Medigap Insurance Covers
Coverage options vary from state to state and city to city and can include all or some of the following Medigap plans.
Plan A: This plan pays your Original Medicare Part B coinsurance or copayment and your coinsurance for Original Medicare Part A. It also provides additional coverage for as many as 365 days of hospital care after you've used all your Medicare Part A hospital benefit. Plan A also covers Original Medicare Part A hospice care copay or coinsurance.
Plan B: The only difference between Plan A and Plan B is that Plan B covers your Original Medicare Part A deductible.
Plan C: Plan C offers the same coverage as Plan B, and it offers the following five additional benefits.
- Pays coinsurance for skilled nursing care facilities
- Pays copayments or coinsurance for Original Medicare Part A hospice care coverage
- Pays the coinsurance and copayments for Original Medicare Part B coverage
- Pays the deductible for Original Medicare Part B
- Covers 80 percent of approved costs for foreign travel emergencies
Plan D: With the exception of the Medicare Part B deductible, Plan D provides the same coverage as Plan C.
Plan F: Considered the most complete option, Plan F offers a low deductible and a high deductible choice. Both options come with the same benefits offered in Plans A, B and C. The only difference is the deductible amount.
Plan G: Another option that provides the same benefits as Plans A, B and C, Plan G goes even farther by covering 100 percent of Original Medicare Part B charges. The deductible for Original Medicare Part B is not covered in Plan G.
Plan K: Unlike the other Medigap plans, Plan K pays a percentage of your costs that allows this plan to offer lower premium payments. Once your annual maximum out-of-pocket amount has been met, Plan K covers all charges and includes the following benefits.
- 100-percent coverage for Original Medicare Part A hospital coinsurance with an additional 365 days of hospital coverage after the original benefit is used.
- 50-percent coverage of your Original Medicare Part A deductibles
- 50-percent coverage of your Original Medicare Part B copayment or coinsurance
- 50-percent coverage of your Original Medicare Part A skilled nursing and hospice care copayment or coinsurance
Plan L: This plan is another low premium Medigap option. It offers the same coverage as Plan K, but it pays 75 percent of costs instead of 50 percent and has a lower out-of-pocket limit.
Plan N: With Plan N, you are responsible for copays for office and ER visits. After you've made the copay, Plan N covers 100 percent of your Original Medicare Part B coinsurance costs.
Every person has different coverage needs and different financial considerations. It's important to remember that not every plan is offered everywhere, so be sure you look for plans and coverages offered in your state of residence and in your location within the state.
What Medigap Insurance Costs
Like coverage options, the costs of Medigap plans differ from location to location and from provider to provider. The following table provides a breakdown of Mutual of Omaha Medigap plan costs in four major U.S. cities. The prices are based on a 76-year-old female non-smoker.
|Mutual of Omaha Medicare Supplement (Medigap) Insurance Rates|
Average Monthly Premiums by Location
|Plan||Columbus, OH||Washington D.C.||Portland, OR||Philadelphia, PA|
|High Deductible Plan F||$61.41||$50.73||$63.08||$87.00|
To find costs and plans specific to your geographic area and healthcare needs, consult a Mutual of Omaha Medicare Supplement plan representative. The agent will give you precise details for your particular situation.
There are two time periods in which you can enroll in a Medigap plan. These windows include the initial enrollment period, which is three months before you turn 65 to three months after, and the annual open enrollment period, which is usually from October 15th to December 7th. During these periods, you can enroll in a Medigap plan for the first time, or you can change to a different Medigap plan. Contact a Mutual of Omaha representative for more information on Mutual of Omaha Medigap Plans. You can also read our Mutual of Omaha Medigap review here.