Original Medicare will cover approximately 80% of your hospital, medical and doctor fees, leaving you to pay the remaining 20% through coinsurance, copayments and deductibles. If you have Original Medicare plus a Medicare supplement plan, Medicare will pay its share of the Medicare-approved amounts for covered health care costs, then your Medigap policy pays its share leaving you with much less out-of-pocket expenses. To simplify, if Medicare covers it, your Medicare supplement plan will, too. Learn more by speaking to our Medicare Supplement Agents in Staten Island.

There are ten Medicare supplement plans to choose from: A, B, C, D, F, G, K, L, M, and N. The plans are standardized by Medicare and all companies must follow these guidelines. No matter which insurance company you purchase your Medicare supplement from, the benefits are exactly the same. The only difference is price.

Once you’re given the healthcare you need, your service provider (doctor or hospital) will bill Medicare. Once billed, Medicare will then pay its portion (80%) and then your Medicare supplement plan will pay its portion. Depending on which Medicare Supplement plan you have, it will either cover all or a portion of the 20% coinsurance gap remaining.

• Medicare Advantage Plans (also known as Part C), like an HMO or PPO
• Medicare Prescription Drug Plans (Part D)
• Medicaid
• Employer or union plans, including the Federal Employees Health
  Benefits Program (FEHBP)
• TRICARE
• Veterans’ benefits
• Long-term care insurance policies
• Indian Health Service, Tribal, and Urban Indian Health plans
• Qualified Health Plans sold in the Health Insurance Marketplace

• You must have Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance).
• If you have a Medicare Advantage Plan (like an HMO or PPO) but are planning to return to Original Medicare, you can apply for a Medicare supplement before your coverage ends.
• You pay the private insurance company a premium for your Medicare supplement in addition to the monthly Part B premium you pay to Medicare.
• A Medicare supplement policy covers one person. If you and your spouse both want Medigap coverage, you each will have to buy separate Medicare supplement plans.
• You can buy a Medicare supplement plan when you have your Medicare supplement Open Enrollment Period.
• All Medicare supplement plans are guaranteed renewable even if you have health problems. This means the insurance company can’t cancel your policy as long as you stay enrolled and pay the premium.