Medicare Supplement Plans, commonly known as Medigap Plans, are essential for anyone looking to minimize the out-of-pocket costs that Original Medicare doesn’t cover. With ten different plans available in Florida, finding the right one can be pretty confusing – where do you even start? Each Medigap plan offers different levels of coverage, making it crucial to know how to compare Medicare Supplement plans to ensure that you choose the best option for your specific healthcare needs.
At Absolute Best Insurance, we understand that choosing a plan can be really confusing. With the Medicare Open Enrollment period running from October 15 to December 7th, now is the time to find the right plan for you.
With over 20 years of experience serving clients across South Florida, we specialize in helping you navigate the complexities of these Supplement Plans. Our dedicated agents in Greenacres, Boca Raton, Port St. Lucie, and Melbourne are here to help you find the right coverage to meet your needs.
This guide will walk you through the details of each available Medicare plan, including Medigap, and provide a checklist to help you make an informed decision.
Understanding Medicare Supplement Plans
Medicare Supplement Plans are standardized insurance policies designed to complement Original Medicare (Part A and Part B). These plans help cover costs like copayments, coinsurance, and deductibles that the original plan doesn’t cover.
It’s important to note that these plans don’t include coverage for prescription drugs (Part D), and they do not cover long-term care, vision, dental, or hearing services.
Key Considerations When Comparing Medicare Supplement Plans
- Coverage Needs: Identify which gaps in Original Medicare you need to fill. For instance, do you require coverage for hospital stays, copayments, or foreign travel emergencies?
- Budget: Determine your budget for monthly premiums and out-of-pocket costs. Plans with lower premiums often have higher out-of-pocket expenses and vice versa.
- Eligibility: Keep in mind that Plan C and Plan F are not available if you turned 65 on or after January 1, 2020. However, if you were eligible before this date but not yet enrolled, you might still qualify.
- Location: Plan availability can vary by location. Residents in Greenacres, Boca Raton, Port St. Lucie, and Melbourne should verify that the plans they’re interested in are available in their area.
- Provider Networks: While these plans generally allow you to see any doctor who accepts Medicare, some insurance companies offer discounts for using their preferred providers.
A Detailed Look at Each Medicare Plan Available including Medigap Plans
Plan A
Overview: Part of Original Medicare, Plan A provides the most basic level of coverage among all available plans.
Plan A covers:
- Part A coinsurance and hospital costs for up to an additional 365 days after your benefits are exhausted.
- Part B coinsurance or copayment.
- The first three pints of blood needed for a medical procedure each year.
- Part A hospice care coinsurance or copayment.
This does not cover the Part A deductible, skilled nursing facility care coinsurance, or any foreign travel emergencies.
Plan B
Overview: As the second part of Original Medicare, Plan B includes all the benefits of Plan A and adds coverage for the Part A deductible. This deductible can be a significant expense, particularly if you are hospitalized, so having this covered can be a substantial benefit.
Plan B covers:
- Part A coinsurance and hospital costs for up to an additional 365 days after your benefits are exhausted.
- Part B coinsurance or copayment.
- The first three pints of blood needed each year.
- Part A hospice care coinsurance or copayment.
- Part A deductible.
Plan B does not cover skilled nursing facility care coinsurance, Part B deductible, or foreign travel emergency coverage.
Plan C
Overview: Also known as Medicare Advantage, Plan C offers comprehensive coverage by covering all the benefits of Plan B and adding coverage for skilled nursing facility care coinsurance, Part B deductible, and foreign travel emergency care (up to plan limits). It’s one of the most extensive extended coverage plans available.
Plan C covers:
- Part A coinsurance and hospital costs for up to an additional 365 days after your benefits are exhausted.
- Part B coinsurance or copayment.
- The first three pints of blood needed each year.
- Part A hospice care coinsurance or copayment.
- Part A deductible.
- Skilled nursing facility care coinsurance.
- Part B deductible.
- Foreign travel emergency care (80% coverage up to plan limits).
Eligibility Note: Medicare Advantage is not available if you turned 65 on or after January 1, 2020. However, those eligible before this date but not yet enrolled can still purchase this plan.
Who Should Consider It: Plan C is an excellent option for those eligible who want comprehensive coverage, especially if they travel abroad frequently and need coverage for foreign medical emergencies. It’s also ideal for individuals who expect to need skilled nursing care and want to avoid the Part B deductible.
Plan D
Overview: Plan D provides coverage similar to Plan C but does not include the Part B deductible.
Plan D covers:
- Part A coinsurance and hospital costs for up to an additional 365 days after your benefits are exhausted.
- Part B coinsurance or copayment.
- The first three pints of blood needed each year.
- Part A hospice care coinsurance or copayment.
- Part A deductible.
- Skilled nursing facility care coinsurance.
- Foreign travel emergency care (80% coverage up to plan limits).
Plan D does not cover the Part B deductible or excess charges.
Who Should Consider It: Plan D is suitable for individuals who want comprehensive coverage similar to Plan C but are willing to pay the Part B deductible out of pocket. This plan is a good fit for those who expect to need skilled nursing care or travel internationally.
Plan F
Overview: Plan F is the most comprehensive Medigap plan available, covering all gaps left by Original Medicare. It covers everything that Plan C covers, plus 100% of Part B excess charges. Excess charges are amounts that a doctor or other healthcare provider may charge over the approved amount.
Plan F covers:
- Part A coinsurance and hospital costs for up to an additional 365 days after your benefits are exhausted.
- Part B coinsurance or copayment.
- The first three pints of blood needed each year.
- Part A hospice care coinsurance or copayment.
- Part A deductible.
- Skilled nursing facility care coinsurance.
- Part B deductible.
- Foreign travel emergency care (80% coverage up to plan limits).
- Part B excess charges.
Eligibility Note: Like Plan C, Plan F is only available to those who were eligible before January 1, 2020.
Who Should Consider It: Plan F is perfect for those who want the most extensive coverage possible and are eligible to purchase it. This plan is ideal for individuals who frequently see healthcare providers who charge more than the Plan-approved amount, as it covers these excess charges.
Plan G
Overview: Plan G offers the same benefits as Plan F, except it doesn’t cover the Part B deductible. However, it covers everything else, including any Part B excess charges and foreign travel emergencies.
Plan G covers:
- Part A coinsurance and hospital costs for up to an additional 365 days after your benefits are exhausted.
- Part B coinsurance or copayment.
- The first three pints of blood needed each year.
- Part A hospice care coinsurance or copayment.
- Part A deductible.
- Skilled nursing facility care coinsurance.
- Foreign travel emergency care (80% coverage up to plan limits).
- Part B excess charges.
Plan G does not cover the Part B deductible.
Who Should Consider It: Plan G is an excellent alternative to Plan F for those who are not eligible for Plan F or for those who don’t mind paying the Part B deductible. It’s a popular choice for new Medicare beneficiaries who want comprehensive coverage.
Plan K
Overview: Plan K is a cost-sharing plan that covers 50% of most Plan-related expenses, including Part B coinsurance, blood, Part A hospice care, and skilled nursing facility care. It also covers 50% of the Part A deductible. Importantly, Plan K includes an annual out-of-pocket limit, which caps your expenses for covered services within a year.
Plan K covers:
- 50% of the Part A deductible.
- 50% of the Part B coinsurance or copayment.
- 50% of the first three pints of blood needed each year.
- 50% of Part A hospice care coinsurance or copayment.
- 50% of skilled nursing facility care coinsurance.
Out-of-Pocket Limit: Plan K includes an annual out-of-pocket limit of no more than $2,000 for 2025 coverage. Once you reach this limit, Plan K covers 100% of approved costs for the rest of the year.
Who Should Consider It: Plan K is suitable for individuals who prefer lower premiums and are comfortable with sharing some of the healthcare costs. It’s a good option for those who want a safety net for high medical expenses but are generally healthy and don’t anticipate needing extensive care.
Plan L
Overview: Plan L is similar to Plan K but covers 75% of the same expenses, including Part B coinsurance, blood, Part A hospice care, and skilled nursing facility care. Like Plan K, it also has an annual out-of-pocket limit, but this plan covers more of your healthcare costs upfront.
Plan L covers:
- 75% of your Part A deductible.
- 75% of your Part B coinsurance or copayment.
- 75% of the first three pints of blood needed each year.
- 75% of Part A hospice care coinsurance or copayment.
- 75% of skilled nursing facility care coinsurance.
Out-of-Pocket Limit: Plan L includes an annual out-of-pocket limit of no more than $2,000 for 2025 coverage. Once you reach this limit, Plan L covers 100% of approved costs for the rest of the year.
Who Should Consider It: Plan L is a good choice for those who want a balance between lower premiums and moderate out-of-pocket costs. It’s ideal for individuals who are healthy but want a little more coverage than what Plan K offers.
Plan M
Overview: Plan M covers 50% of the Part A deductible and full coverage for most other expenses, including Part B coinsurance, blood, and hospice care. Unlike Plans K and L, Plan M does not have an out-of-pocket limit.
Plan M covers:
- 50% of Part A deductible.
- Part B coinsurance or copayment.
- The first three pints of blood needed each year.
- Part A hospice care coinsurance or copayment.
- Skilled nursing facility care coinsurance.
- Foreign travel emergency care (80% coverage up to plan limits).
Plan M does not cover the Part B deductible or excess charges.
Who Should Consider It: Plan M is a good fit for those who want lower premiums and are comfortable with some cost-sharing for hospital stays. It’s particularly suitable for individuals who are relatively healthy and don’t anticipate needing extensive medical care.
Plan N
Overview: Plan N offers comprehensive coverage similar to Plan D but requires copayments for certain services. You’ll pay a small copayment for some doctor visits and emergency room visits that don’t result in an inpatient admission.
Plan N covers:
- Part A coinsurance and hospital costs for up to an additional 365 days after your benefits are exhausted.
- Part B coinsurance (after a $20 copayment for office visits and a $50 copayment for emergency room visits that do not result in inpatient admission).
- The first three pints of blood needed each year.
- Part A hospice care coinsurance or copayment.
- Part A deductible.
- Skilled nursing facility care coinsurance.
- Foreign travel emergency care (80% coverage up to plan limits).
Plan N does not cover Part B excess charges or the Part B deductible.
Who Should Consider It: Plan N is ideal for those who want lower premiums and are comfortable with small copayments. It’s a good option for individuals who expect to need some medical care but want to keep their premiums affordable.
How to Compare Medicare Supplement Plans in Florida
When comparing Medigap plans, it’s essential to evaluate how each plan fits with your healthcare needs. Here’s a checklist to help guide you:
- Review Coverage Details: Compare what each plan covers, paying close attention to how it complements Original Medicare. Ensure the plan covers the gaps that matter most to you.
- Evaluate Costs: Compare premiums and out-of-pocket costs. Some plans, like Plan F and G, offer more comprehensive coverage but at higher premiums. Others, like Plan K and L, have lower premiums but higher out-of-pocket expenses.
- Check Availability: Ensure the plan is available in your area. Residents in Greenacres, Port St. Lucie, Boca Raton, and Melbourne should verify local availability.
- Consider Provider Networks: While most of these extended coverage plans allow you to see any doctor who accepts Medicare, some insurers offer discounts for using their network.
- Understand Eligibility Requirements: Especially important for those considering Plan C or Plan F, make sure you meet the eligibility requirements.
- Consider Future Needs: Think about how your healthcare needs might change. If you anticipate needing more comprehensive coverage in the future, it might be worth paying a higher premium now.
Why Choose Absolute Best Insurance?
For over 20 years, Absolute Best Insurance has been helping clients from Greenacres to Melbourne navigate the complexities of Medigap Plans. Our team specializes in all available Medicare plans, health insurance, ACA coverage, and more. We work closely with you to create an individualized solution tailored to your specific needs.
| “Choosing the right Medigap plan can be daunting. Our dedicated agents in Boca Raton, Port St. Lucie, and beyond are here to guide you every step of the way. We help you ask the right questions and find the plan that best meets your needs.” |
| – Stacy Murphy, Owner/Operator of Absolute Best Insurance |
Whether you’re in Greenacres or Melbourne, our agents are here to provide expert guidance, ensuring you choose the best Medigap plan for your needs. From the Space Coast to Palm Beach County, Absolute Best Insurance is your trusted partner in finding the right Medicare Supplement Plan.
In Conclusion
To learn how to compare Medicare Supplement plans, it’s essential to consider your current and future healthcare needs, your budget, and your eligibility for certain plans. Use this checklist to make an informed decision, and remember that Absolute Best Insurance is here to help you navigate the process.
With our expertise and personalized service, you can confidently choose the plan that provides the coverage and peace of mind you deserve.
Simply click here or give our dedicated agents a call at (561) 420-0280 for a free, no-obligation quote.