What Are Medicare Supplement Plans in Illinois?
Medicare is a health insurance plan for people age 65 or older and younger people with disabilities and end-stage renal disease (ESRD). It has two parts: Medicare Part A, which is your hospital insurance, and Part B, which is your medical insurance. You pay a monthly premium for Part B.1 2
While Medicare helps pay for healthcare, it has copays, coinsurance and deductibles, which can lead to high out-of-pocket costs. An Illinois Medicare Supplement plan helps to cover those expenses.
Medicare Supplement insurance plans, also known as Medigap policies, are lettered A-N and standardized. This means a Plan G from one insurance company has the same benefits as a Plan G from another company.3
What You Need to Know
The best time to enroll in a Medigap policy is during your Medigap Open Enrollment Period.
The most popular plans are Plans F, G and N.
The Senior Health Insurance Program (SHIP) provides free counseling to Illinois residents on Medicare.
When Can You Enroll in a Medigap Policy?
You can apply for a Medigap policy any time after you’re eligible for Medicare. Insurance companies can use medical underwriting to determine your eligibility unless you’re in your Medigap Open Enrollment Period or you have guaranteed issue rights.
Your Medigap Open Enrollment Period starts the first day of the month you are both age 65 or older and enrolled in Medicare Part B. During this period, insurance companies must sell you a Medicare Supplement plan and they can’t charge you more due to any health conditions you have.4
You have guaranteed issue rights in specific situations. Typically, the circumstances involve losing coverage through no fault of your own or switching to a Medicare Advantage (MA) plan and deciding to switch back to Original Medicare within the first year of having the MA plan.5
What Are the Most Popular Medicare Supplement Plans?
Medicare Supplement Plan F has the most benefits of any plan. It covers the following:
- Medicare Part A coinsurance
- Medicare Part B coinsurance
- The first three pints of blood
- Medicare Part A hospice care coinsurance or copayment
- Skilled nursing facility care coinsurance
- Medicare Part A deductible
- Medicare Part B deductible
- Medicare Part B excess charges
- Up to 80% of foreign travel emergency costs up to plan limits
Part B excess charges arise when providers charge more than the Medicare-approved amount. Providers can charge up to 15% more than what Medicare approves, but Plan F covers these extra charges.7
Unfortunately, people who started Medicare on or after January 1, 2020, can’t purchase Plan F.
Plan G covers everything Plan F does except for the Part B deductible. Plan N covers everything Plan F does except for the Part B deductible and Part B excess charges. Plan N also has a copay of $20 for some office visits and $50 for emergency room visits that don’t result in an inpatient admission.8
Comparison Shop for Plans
After you decide which lettered plan, A-N, might best meet your needs, check several insurers to see which ones in your area of Illinois offer the best price.
How Do You Choose a Medicare Supplement Plan?
Next, use the Medicare Plan Finder to find companies that sell Medicare Supplement plans in Illinois. Contact multiple companies to compare plan prices.
It’s important to do this because plan prices vary, even though the plans are standardized and offer the same benefits. The reason for this is that insurance companies use one of three pricing structures:
- Attained age ratings: With this plan option, insurance companies base prices on your current age. These premiums may be the lowest when you’re younger and the most expensive as you age.
- Issue age ratings: With this pricing structure, premiums are lower if you buy the plan when you’re younger and won’t increase due to age. Premiums may increase due to inflation or other factors, however.
- Community age ratings: Companies that use this option charge the same premiums to everyone regardless of age. Premiums may increase due to inflation, however, as well as other factors.9
Do Medicare Supplement Plans Include Prescription Coverage?
No Prescription Drug Coverage
Keep in mind that Medicare Supplement plans do not include prescription coverage. For that, you may need a separate Medicare Part D plan.
How Much Do Medigap Policies Cost?
In Illinois, a 65-year-old male who doesn’t use tobacco would pay:
- $151-$420 for Plan F
- $119-$396 for Plan G
- $97-$377 for Plan N
A 65-year-old woman who doesn’t use tobacco would pay:
- $131-$372 for Plan F
- $106-$351 for Plan G
- $84-$334 for Plan N
What If You Want to Change Your Medigap Policy?
You can apply for a different Medigap policy at any time. Keep in mind that insurance can decline your application or charge you more based on your health unless you have guaranteed issue rights.11
What Are Alternatives to Medicare Supplement Plans?
Medicare Advantage (MA) plans are an alternative to Medicare Supplement plans. A Medicare Advantage plan provides all your Medicare Part A and Part B benefits, and most also offer Medicare Part D prescription drug coverage.12
What Are Medicare Resources in Illinois?
An Illinois Medicare beneficiary has access to several resources.
- Senior Health Insurance Program (SHIP): This program provides free counseling to people on Medicare. Contact SHIP at 1-800-252-8966 or firstname.lastname@example.org.
- Illinois Department of Insurance: If you have an issue with your Medicare Supplement plan, contact the Department of Insurance. You can file a complaint online.
- Medicaid: This program provides free or low-cost healthcare to people with limited income and assets. You can apply online or by calling 1-800-843-6154.
To find the right Medicare Supplement for you, review your plan options and contact multiple insurance companies. Be sure to compare plans with the same letter so you’re making an apples-to-apples comparison. Consider reviewing Medicare Part D prescription plans as well. If you have questions, Illinois has several resources that can help.