Medicare Supplement Policies

Medicare Supplement policies are designed to help pay for health care costs not paid by Medicare, including deductibles and co-insurance. The following is important to know about Medicare Supplement policies:

• They are often referred to as “Medigap” policies.
• They only cover one person. Spouses are responsible for obtaining their own coverage.
• The insured is responsible for paying the monthly premium.
• The policy is guaranteed renewable.
• The policy can be terminated only for nonpayment of premium or material misrepresentation. A material misrepresentation means you intentionally answered a question incorrectly on the application, and if the insurer would have known the correct answer, you would have been ineligible for the insurance plan or the plan would have been issued to you at a different premium.

What You Should Know

The best time to purchase a Medicare Supplement policy is during your open enrollment period. Your open enrollment period begins on the first day of the month in which you are both age 65 or older AND enrolled in Medicare Part B. This period lasts six months, during which you can purchase any Medicare Supplement plan, even if you have a pre-existing health condition. If you apply for a Medicare Supplement policy after your six-month open enrollment period, you are subjected to the insurer’s medical underwriting criteria and may be denied and/or rated based on your health conditions.

You may be able to purchase a Medicare supplement policy with guarantee issue rights when you have other health coverage, including Medicare Advantage or a Medicare supplement policy, that changes in some way (such as when you involuntarily lose coverage). If you qualify for guarantee issue rights, you have 63 days to apply for new coverage under the standardized Medicare supplement plans A, B, C, F, High Deductible Plan F, K or L. Individuals newly eligible for Medicare on or after January 1, 2020:

Plan C is reassigned as Plan D
Plan F is reassigned as Plan G
Plan F with high deductible is reassigned as Plan G with high deductible.

Please see Medicare Access and CHIP Reauthorization Act of 2015 for additional information related to plan reassignments. For more information regarding guaranteed issue rights, contact DIFS at 877-999-6442 or the Michigan Medicare/Medicaid Assistance Program (MMAP) at 800-803-7174.

If you are under the age of 65 your choices of Medicare Supplement policies are generally limited to a Medicare Supplement Plan A or Plan C. There are a limited number of health insurers that must offer Plans A and C to persons under the age of 65. Companies that are required to offer Plans A and C to persons under the age of 65 are allowed to charge those individuals more for the coverage. Individuals newly eligible for Medicare on or after January 1, 2020: Plan C is reassigned as Plan D. Please see Medicare Access and CHIP Reauthorization Act of 2015 for additional information related to plan reassignments.

• Hospitalization: Part A co-insurance plus coverage for 365 additional days after Medicare benefits end
• Medical Expenses: Part B co-insurance (generally 20 percent of Medicare-approved expenses) for hospital outpatient services
• Medicare Part A and B blood coverage: first three pints of blood per calendar year
• Medicare Part A hospice co-insurance

• Core benefits
• Medicare Part A deductible
• Skilled nursing facility care
• Medicare Part B deductible
• Medically necessary emergency care in a foreign country

Plan D includes:

• Core benefits
• Medicare Part A deductible
• Skilled nursing facility care
• Medically necessary emergency care in a foreign country

Plan F includes:

• Core benefits
• Medicare Part A deductible
• Skilled nursing facility care
• Medicare Part B deductible
• 100 percent of Medicare Part B excess charges
• Medically necessary emergency care in a foreign country

High Deductible Plan F includes:

• All Plan F benefits
• While premiums are typically lower under the high deductible option, the insured is required to pay the deductible before the policy will cover your health claims
• The deductible for this plan changes annually

Plan G includes:

• Core benefits
• Medicare Part A deductible
• Skilled nursing facility care
• 100 percent of Medicare Part B excess charges
• Medically necessary emergency care in a foreign country

Plan K includes:

• Core benefits
• 50 percent of the cost-sharing for Medicare Part A covered hospice expenses
• First three pints of blood
• 50 percent of the Part B co-insurance after meeting the annual deductible
• Payment of the Part A and B deductibles, co-payments, and co-insurance once the annual out-of-pocket spending limit is met
• The deductible for this plan changes annually

Plan L includes:

• Core benefits
• 75 percent of the cost-sharing for Medicare Part A covered hospice expense
• First three pints of blood
• 75 percent of the Part B co-insurance after meeting the annual deductible
• 100 percent of the Part A and B deductibles, co-payments and co-insurance, once the annual out-of-pocket spending limit is met.
• The deductible for this plan changes annually

Plan M includes:

• Core benefits
• 50 percent of the Medicare Part A deductible
• Skilled nursing facility care
• Medically necessary emergency care in a foreign country

Plan N includes:

• Core benefits
• Medicare Part A deductible
• Skilled nursing facility care
• Medically necessary emergency care in a foreign country
• 100 percent of the Part B co-insurance, except up to $20 co-payment for office visits and up to $50 for emergency department visits