When people ask us about the top rated Medicare Supplement plans also known as Medigap policies, we are often asked as to which of the Medicare Supplement plans is the best.
You know, that is a tough answer to give in many cases. I often advise people to consider the 3 most popular and comprehensive policies available.
The top 3 Medicare Supplements are Plan F, Plan G and Plan N by the numbers. They simply offer more bang for the buck and/or very high client satisfaction is very high.
These plans have also been consistently rated “best” by our clientele and those of many other long time senior benefit agents and brokers I am familiar with.
How Do Medicare Supplement Insurance Plans Work With Medicare Itself?
With the risk of high out of pocket health care costs as a senior, having both Original Medicare and a Medicare Supplement (Medigap policy) is a wise decision.
Studies have shown that seniors in their mid sixties spend nearly 58% of their Social Security income on health related care.
Be careful you do not consider Medicare Advantage (not Original Medicare) and a supplement. Medigap/ Medicare Supplements do not work with Medicare Advantage only Original Medicare.
There are 10 + different Medicare Supplement (Medigap) plans that are available across the country. There are 3 states that are a bit different. Massachusetts, Minnesota and Wisconsin have their own plan standards.
In 1992, Medicare “Standardized” Medicare Supplements (Medigap) into 10 different plans.
What this means to you is “Plan N” or “Plan G” and even “Plan F” offered by insurance company A, will be identical to insurance company X, company X, Z and so on. The premiums will differ sometimes substantially company to company, but the benefits and coverage are identical from one company to the next as long as you compare the plan letters correctly.
Medicare Supplements are offered by private insurance companies.
Now, not all 10+ plans will be available with each of them, but they cannot simply adjust the plan benefits to their advantage.
As of January 2020, the federal MACRA laws changed guaranteed issue plans. Plan D and Plan G will become the guaranteed issue offerings for those who qualify.
A company that wishes to offer more than one Medicare Supplement plan must also offer Plan G. These are for guaranteed issue situations.
While there is a popular rumor circulated by plenty of misinformed folks, there is not a best or top Medicare Supplement insurance company.
ABC insurance company’s Plan G is not better than Plan G from XYX insurance company.
The federal Medicare system strictly regulates the performance requirements of all Medicare Supplement (Medigap) policies. Original Medicare leaves no wiggle room for insurance companies to deny Medicare approved charges unless you do not have those benefits in your supplemental plan selection. For example, don’t expect a Plan A to cover your care the way any of the 3 top Medicare supplement plans would.
Your claims, if approved by Medicare, are electronically sent over to any Medicare Supplement (Med Supp) you may own.
The best rated Medicare Supplement plans will pick up your remaining responsibility according to the defined benefits based on the plan letter you selected.
If Medicare denies your claim, all insurers will pay zero. Don’t be confused here. That is how the system works.
Many folks are curious about which Medicare Supplement policy is the most popular. If you go back to the late 90’s when I started working with seniors forward to 2018, I would say the Plan F by a good margin. However, due to the Macra law changes of 2020, this has impacted who can purchase a Plan F. As of 2023, the Plan G seems to be the most popular.
This is been a personal favorite of mine as an agent for most of my career. This plan has always offered comprehensive coverage at a competitive rate. Plan G has really taken off in recent years due to its cost versus the benefits it offers. However, the 2020 Macra laws are affecting the rates of the Plan G. This should be discussed with your professional.
Plan N is the newer kid on the block and a plan to consider. It has risen in popularity since 2019, well in excess of 30%. Plan N, like Plan F and Plan G has become very popular.
Choosing the right plan for you will be dependent on what is most important to you. Let’s cover what is “covered” in the 3 most popular Medicare Supplements.
Plan F
Plan F has been the Cadillac of Medicare Supplements for a number of years.
With the Plan F, it is hard not to say you don’t have one of the top rated Medicare Supplement plans out there. It is fully comprehensive in terms of medical benefits and offers first dollar coverage. You pay nothing for any approved Medicare healthcare claim.
Important Note: As of January 1, 2020, Plan F is no longer available to anyone not Medicare eligible as of that specific date. Sorry, both plan C and F are only available to those people who were eligible for Medicare at that time. You must be an eligible Medicare recipient prior to 2020 to apply and purchase this plan.
If Medicare approves a charge, Plan F picks up and pays the 20% that Medicare will not. It will also cover charges that are above and beyond what Medicare approves. These charges are called “excess charges.” Providers that don’t accept Medicare as payment in full are allowed to charge up to an additional 15%. Plan F will cover all of these charges as well.
As you probably expected, you’ll be paying considerably more in premiums for the convenience of Plan F. Be sure to consider all of the positives and negatives before you make a decision.
What is covered under Medicare Supplement (Medigap) Plan F
- The Part A and Part B Deductibles
- Part A and Part B coinsurance, No Co-payments required
- Hospital coinsurance for up to 1 full year after Medicare Part A (Hospitalization) benefits are expired
- Any Part B Excess Charges
- Hospice Care Coinsurance
- Skilled Nursing Coinsurance
- First 3 pints of blood per year (for approved procedures)
- Foreign Travel Emergency Care to 80% (up to plan limits)
Since Plan F offers all the bells and whistles, it is the most expensive plan. Historically, larger rate increase over multiple years can be expected. However, it is a full featured, no hassle plan where it’s owners are typically very satisfied. You do not have to track anything that Medicare approves as Plan F will take care of the balance. “Deeper Pockets” are recommended for those who like the ease of ownership the Plan F offers.
Plan G
Medigap Plan G is outselling almost all other plans in 2023 because it does have the same comprehensive coverage as Plan F except for the Part B deductible of $226 (for 2023).
If you put Plan F and Plan G side by side, the only difference is the yearly, Part B deductible. After that is paid each year, both plans will have identical coverage.
While that deductible can and will likely go up in future years, Plan G is still a comprehensive and fixed expense Medicare Supplement that is very cost effective.
Plan G strikes a very solid balance between full benefits and affordability making it arguably the best value Medicare Supplement (Medigap Plan).
Before I move on to the next Medigap plan, I want to stress a sometimes overlooked benefit of both Plan F and Plan G.
That benefit is called “Part B Excess Charges.”
While this benefit is sometimes over touted, it does take away any risk of charges from a provider that does not accept Medicare assignment as payment in full. By law, these particular providers can charge you up to 15% beyond the Medicare approved amount. Now this may not seem like much for a typical doctor visit, but a trip in an ambulance, air lift, or even oxygen providers can may not accept Medicare assignment as payment in full. Some of those bills can be substantial. While I do not see this as common, it remains a gap in coverage you can elect to close with this plan.
While Plan F is not available to Medicare beneficiaries who became eligible as of January 1, 2020, Plan G offers those individuals very comprehensive coverage.
Something to consider even for those recipients who have a prior Plan F and “grandfathered” in.
What is covered under Medicare Supplement (Medigap) Plan G
- The Part A Deductible
- Part A and Part B coinsurance, No Co-payments required
- Hospital coinsurance for up to 1 full year after Medicare Part A (Hospitalization) benefits are expired
- Any Part B Excess Charges
- Hospice Care Coinsurance
- Skilled Nursing Coinsurance
- First 3 pints of blood per year (for approved procedures)
- Foreign Travel Emergency Care to 80% (up to plan limits)
Plan G has quickly become the most recommended Medicare Supplemental plan available. Why? It drives excellent value by offering near top of the line benefits with a considerably lower premium and has typically moderate rate increase history versus the Plan F. Interjecting some personal opinion here…Plan G deserves to be a top contender for the “best” Medicare Supplemental insurance plan without a doubt for many seniors.
Plan N
In very recent years, Medicare Supplement Plan N has become a top contender as it offers a good balance between out of pocket costs and lower premiums. It is not as comprehensive as Plan F and G. However, it is an excellent plan for good protection and minimal, long term rate increases.
Under Medicare Supplement/Medigap Plan N you have many of the same benefits as the Cadillac, Plan F. The exceptions are as follows:
- No coverage for the Part B deductible ($226 in 2023)
- No coverage for Part B Excess Charges
- You will also have up to a $20 copay for doctor visits, outpatient treatments etc. and up to $50 for visits to the hospital when you are not admitted.
Now Plan N is a new kid on the block in that it came out in 2010. While the Plan N is not a Plan F, if offers some moderate cost sharing in exchange for a lower premium. Unlike Plan F, Plan N will be around past 2020.
What is covered under Medicare Supplement (Medigap) Plan N
- The Part A Deductible
- Part A and Part B coinsurance, Co-payments required. $20 for office visits, $50 copayment for emergency room visits that do not result in hospital admission
- Hospital coinsurance for up to 1 full year after Medicare Part A (Hospitalization) benefits are expired
- Hospice Care Coinsurance
- Skilled Nursing Coinsurance
- First 3 pints of blood per year (for approved procedures)
- Foreign Travel Emergency Care to 80% (up to plan limits)
While Plan N is not as feature rich as the previous two plans, it has a good history of the lowest annual rate increases from company to company. Plan N is the newest of these 3 plans and is a good bet if your budget is tight and on Original Medicare.
Does A Medicare Supplement Cover Part B Excess Charges?
You may have noticed that there was an obvious benefit missing from Plan N that is included in both the Plan F and Plan G Medigap offerings. Plan N does not include Part B Excess Charge coverage. So what are Medicare Part B excess charges? First of all, it is a charge outside hospitalization that falls under outpatient care (Part B of Medicare).
The health care must be approved by Medicare.
By law, any provider that participates with Medicare that does not accept “assignment” of Medicare benefits may charge you an additional 15% above and beyond Medicare approved amounts.
You would be responsible for these charges if they were incurred to meet your healthcare needs.
Specialists, ambulance services, oxygen providers are the more frequent service providers who may not accept Medicare “assignment” as payment in full and balance bill you the 15%.
While most providers that participate with Medicare accept Medicare approved amounts as payment in full, you may incur these charges at some point. Plan F and Plan G are the only Medigap plans now available that have this benefit.
The Top Medicare Supplement Insurance Companies
I’ve decided to write a section here to address this question or rumor you may have experienced. First and foremost, to clear things up quickly…no Medicare Supplement/Medigap insurance company pays “better” than another company. Medicare has seen to that.
In the Medicare Supplement business, there are no top rated supplemental insurance companies. Well, in volume and financial condition yes, but that is does not mean they pays claims better.
In different states there are certain insurance companies that tend to dominate the market. Not all insurance companies operate in the majority of the 50 either. We are located in Michigan, but use companies in other states that are not available or competitive in Michigan.
The top Medicare Supplement insurance companies will have been in the Medigap industry for a few years at a minimum and priced their coverage competitively during that entire time.
Issues tend to arise when a new Medigap insurer enters the market trying to gather policy holders. New insurers tend to offer a low teaser rate to undercut some of the high volume insurance companies.
Most reputable agents want their clients to get the best coverage they can afford. Sometimes, however, lack of experience in the field results in a large rate increase that both the agent and his/her client were shocked by. The new Medigap insurer gets approved by the state for what is really costs them to cover the volume of business they now have.
With all of that said, when you compare “apples to apples” by Medicare Supplement plan letter, they all payout claims identically.
The question to ask your insurance man is how long has this company been in the Medicare business?
Other key points to remember, Medicare standardized all plans in 1992.
Claims are electronically filed with each insurer and payments are regulated by the state and federal government (Medicare).
As an independent specialist working in this industry, I can tell you that senior policyholder satisfaction is based on a few basic factors.
- The Medigap plan chosen
- The cost of ownership of the plan
- The average rate increase of that plan over time
- Financial rating of the insurer (Use A.M. Best for this)
Don’t over complicate your decision on a supplemental insurance company. It is a waste of mental energy and time. An expensive Plan F from XYZ insurance company will not pay better than ABC insurance company that is 20% less for the same Plan F. If you have heard otherwise, that opinion is from a lack of understanding of the Medicare system and rumors.
Those electing XYZ are just being overcharged most of the time. A seasoned Medicare specialist can help you sort this all out.
Don’t clutter your mind with the hogwash. There is no top rated Medicare Supplement insurance company. Our big name company policyholders are no happier than those with the smaller, lesser known names that are just as competitive.
If you need to get some additional help with understanding how Medicare and Medigap work, read this article breaking down Medicare a bit more.
The Take Home When Comparing Plan F, Plan G and Plan N
We have given you the top 3 Medicare Supplements for your consideration. The best Medicare Supplement by unanimous vote is one of these 3 plans. Some of it is a personal experience of ownership and satisfaction which dictates the results.
Over time, it is just value or simply affordability which influences the decisions seniors on Medicare.
Be sure to always consider which plan would be best for you. Unless you are in your Open Enrollment, you will typically have to qualify based your health. Some states have exceptions to this rule.
Electing the wrong plan for yourself could pose a problem down the road. A change in health is much more common and may result in an inability to change plans or carrier.
After your initial one time Open Enrollment (6 months), you’ll typically be required to pass medical underwriting each time you apply for a change in either carrier or plan. In other words, you will have to answer health questions on any Medicare Supplement application to see if you can qualify.
Unfortunately, this means you can be refused coverage by one or more insurers. Each insurance company has some variance in their health questions for qualification.
Though you may not be acceptable at certain companies does not mean there might not be any hope elsewhere. Speak to your independent senior benefits specialist about your options.
Now, there are also some states that have a small exception to this. These exceptions have an annual enrollment period based around the month of your birthday. These state allow you to change your plan without medical underwriting or a “rated” premium charge.
The key here is…same or lower benefits than the current plan you own. Upgrading your coverage is not possible without medical underwriting.
Medicare Supplements in Conclusion
As I wrap this up, there are 3 top Medicare Supplements that “stand out from the crowd” but you must decide what the “best” Medicare Supplement is for you.
Really, it comes down to how much “skin” do you want in the game and how affordable it is for you. A Plan F covers everything as long a Medicare approves the providers charges. It comes at a higher price tag than the to others.
There are some big changes as of January 1, 2020 (MACRA) that are impacting future rate increases of not only on Plan F, but also Plan G. In fact, it has already begun. The scope of why we are anticipating greater increases in rates with Plan G for the future is a bit beyond the scope of this article.
Plan N is best positioned to maintain lower rate increases into the future. There are states which require insurance companies to spread out any rate increases among all the Medicare Supplement plans the insurer offers in the state. With that said, you should keep this in mind as you are making your healthcare decisions.
The best Medicare Supplement plans for most seniors will be one of these 3 based on years of feedback from seniors.
However…
Make sure you discuss these options with a Medicare specialist like Maple Valley Insurance Group if you are at all unsure of yourself.
Buying the Best Medicare Supplement Insurance Policy
Ladies and Gentleman…
The 3 plans shown here today are identical from insurance company to insurance company. Medicare standardized this back in 1992. You can find this in the “Medicare and You” yearly guide. In Medicare’s guide, it clearly states it is “important” to compare costs for the same plan from the different companies. In no way have they suggested that one company offers top rated Medicare Supplement insurance compared to any others. Medicare, over the years has been clear that you should consider the appropriate plan and compare the pricing. Your independent agent is going to be your guide and advocate beyond this.
Buying a Medicare Supplement plan is generally best served by electing an insurance company that has many policies on the books in your state and/or has demostrated a consistent, competitive history in the Medigap business. A good and seasoned independent agent/broker will know this. Further, understand you may be “rated up” or unable to qualify for some insurance companies based on your health.
It is very important you are working with someone who can shop the market and overall health to find the right carrier for you. Forget about the “top Medicare Supplement insurance company.” United Healthcare for example has a lot of business around the country. They have paid AARP a license fee and received endorsement to stamp their policies with the AARP brand name.
While we do have a business relationship with them, we don’t write them over Mutual of Omaha or Aetna necessarily. All 3 companies are serious about the Medigap business across most of the US. We also you other insurance carriers as well. Maybe not household brand names but serious about the business and competitive.
There is just NO Best Medicare Supplement insurance company. They all pay the same according to the plan letter you select and buy. Medicare regulates these supplemental, Medigap insurers. Plan F is superior in benefits to a Plan G which is superior to a Plan N. It is the plan letter you select and the cost over time that matters. You get the point.
Insurance carriers have no choice once Medicare approves a medical claim. They must pay exactly as the Plan Letter requires.
Original Medicare is not the same as Medicare Advantage. There is no gray area.
Take a look at the Medicare and You Guide and review the different Medicare Supplement plans available. If you choose a lower benefit supplemental plan, it will not perform the same as a Plan F or G. It isn’t because you didn’t waste money on a ultra high priced, Globe Life Medicare Supplement plan.
Do not lose site on limitations of Medicare though…
Medicare and Medicare Supplements may not pay for all your health insurance claims. For example, vision exams, hearing aids, etc. It must be a covered service. If Medicare does not pay its portion, no Medicare Supplement plan will pay a dime either. Medicare Supplements are not for paying claims that Medicare itself denies. A Medicare Supplement is a complement to Original Medicare approved claims. If you want additional benefits and like the freedom of Original Medicare + Medigap Insurance, you would want to talk to a health insurance professional about non Medicare policies designed for seniors that would cover these uncovered costs.
Medigap plans are regulated at both the Federal and State levels. There are no exceptions. If a claim is denied by Medicare, that is the first problem to question and/or correct, not the supplemental insurance company. You don’t need to change your Medigap carrier because a bill did not get paid.
The reality is, the claim just may not fall under Medicare’s coverage. This means the supplement will also deny the claim. Medicare = 80% of approved charges Supplement = 20% with full coverage Plan F for example. That is how things work. Law of the land.
If you are still on the fence, by all means give us a call. Our consultation is always free.
Working with dozens of different insurance companies, we can help you analyze the Medicare Supplement plans, the insurance companies and all their premiums. This way, you are well educated and able to be in the best plan and carrier for you. Always remember, the key to making a change is your health while on Original Medicare. Take action while you are thinking about your Medicare sooner than later. As a general rule, it will be to your advantage to do so.
Hope this article has helped you out. If you have any comment, feel free to leave it below. We’re here to help. 269-244-3420