Are Medicare Supplement Plans Worth The Extra Cost?

By: Lewis Mark
Published: Wednesday, February 27 2019
Last Updated: 5 years ago

Medigap plans have become increasingly popular among Medicare beneficiaries for the added benefits and peace of mind they provide. However, between the extra costs and fixed budget many American seniors are living on, are Medicare Supplement plans worth it?

If you’re still on the fence, know that you’re not alone. Supplemental insurance isn’t for everyone but can provide immense benefits for those in need. We’ve decided to put together an article to help you work through this crucial decision regarding your healthcare, and help you determine whether or not you need Medigap coverage.

Are Medigap Plans Worth It?

There is no simple answer to that question because it varies depending on the individual, but let’s start with the basics to create a good foundation for your decision.

When most become eligible for Medicare, they are automatically enrolled in Medicare Part A and then sign up for Medicare Part B, which make up Original Medicare. These two parts work symbiotically to provide you with healthcare coverage which provides you with benefits for about 80% of the medical costs you may incur.

That leaves you responsible for 20% of the remaining costs, which may seem too daunting at first glance. However, it’s important to note that there is no out-of-pocket maximum, which means 20% of your medical bill can easily turn into a hefty sum. That’s exactly where Medigap plans come into play.

Medicare Supplement plans, also called Medigap coverage, protect you from the out-of-pocket costs you are responsible for. They do come with an added monthly premium, which may be a deterrent for some, but depending on your personal situation, it may be a way to save big money.

Medicare Supplement plans are worth it for any number of the following reasons:

  • You have a pre-existing or chronic health condition.
  • You personally have an extensive medical history.
  • You frequently find yourself seeking out medical attention.
  • You have a planned medical procedure coming up in the near or distant future.
  • You are concerned about potential out-of-pocket expenses your Medicare won’t cover.

If you answered yes to any of the above questions, then yes, a Medigap plans are worth it for you. Even if you didn’t answer yes to any of the above questions, it’s still important to consider a Medicare Supplement plan when you first become eligible, due to the fact you can’t be denied coverage for pre-existing conditions.

Be aware that states have different insurance ratings that affect the cost of supplemental insurance. Some are by community health factors, some age of participants, and others by the health of participants. Some states, like Massachusetts, Wisconsin, and Minnesota, have their own standardized plans. It is helpful to know how the state you live in rates risks for Medicare Supplement coverage.

Medigap Pros And Cons

Are Medicare Supplement plans worth it? Yes, we’ve laid out a pretty strong case in favor of Medigap coverage. That being said, we still want to go over the pros and cons to more clearly illustrate how exactly these policies can help save you money, along with some potential drawbacks.

What Are The Benefits?

Medigap Supplemental insurance pays for things Original Medicare doesn't and that is its biggest advantage. That includes deductibles, copayments, coinsurance, and other out-of-pocket expenses. This can be a big help to those seniors finding themselves at the doctor's office or drug store more frequently.

Another primary advantage of Medigap Supplemental insurance if you have a range of providers that accept it. It is accepted anywhere Medicare is, so you can choose any healthcare provider you need.

With Medigap, there is a range of simple plans you can buy depending on your state. There are a total of 10 standardized plans, soon to be 9, across the nation from which to choose.

Another advantage of Medigap is it covers some medical expenses while traveling. This includes both domestic and international travel. This is a huge advantage for seniors who want to spend their golden years with road trips, cruises, and vacations.

What Are The Drawbacks?

There are a handful of potential drawbacks to Medicare Supplemental plans that you should be aware of before finalizing your decision. So, let’s start with the one con that may be at the forefront of your mind, cost.

Medicare Supplement plans can be costly when it comes to monthly premiums. Now, the costs may be made up quickly if you find yourself needing any sort of medical treatment or service, although, your monthly premiums may be in vain if you don’t.

Other cons to Medigap plans are stemmed in the enrollment process and the ability to switch coverage options if needed. We touched on it earlier, but one thing people fail to realize is that Medicare Supplement plans are often difficult to enroll in after your initial enrollment period. Once enrolled, depending on your health, it can also be difficult, if not impossible, to switch your Medigap coverage to a one more suitable for your financial needs.

With Medigap coverage, your costs may not be fully covered depending on the plan you enroll in. That could leave you paying monthly premiums on top of out-of-pocket expenses, which can quickly add up. You also won’t be covered for any costs associated with the costly prescription medication, you’ll need to enroll in Medicare Part D as well. Treatment considered holistic, like acupuncture, may not be covered as well.

Should You Get A Medicare Supplement Plan?

That depends largely on numbers. Namely, it depends on how much you would need what a supplemental plan offers compared to a Medicare Advantage plan. Calculations must include annual out-of-pocket expenses, prescription costs, the cost to buy a Part D plan, how much you plan to travel and the cost of separate dental and vision plans. You must also compare the cost of Medigap plans versus Medicare Advantage plans.

Seniors must then run the same numbers under their Medicare Advantage plan options to see which plan would financially serve them best. After that, you must take into consideration things like doctor and hospital choices and what you anticipate your health to be like over the next couple of years. There are times you can make a switch, but there are also restrictions so be aware of all the rules.

Compare Quotes With FirstQuote Medicare

If you’re still undecided about whether or not Medicare Supplement plans are worth it, why not talk to an experienced agent? With FirstQuote Medicare, you’ll have the ability to speak with industry professionals at no cost to you and get insider knowledge as to whether or not you’re making the right choice.

If you’re someone who just wants to compare potential costs, our one of a kind Medicare Supplement quoting tool will place plans and pricing side by side in your area. All you have to do is enter your zip code to get started, and you can get help making your decision today.