What You Need to Know
Original Medicare covers many of your healthcare expenses, but you’re still responsible for some costs like copayments and deductibles. Medigap policies help to cover those out-of-pocket expenses.
You’ll need to enroll in Medicare Parts A and B to qualify for a Medigap policy. It’s easiest to sign up during your Medigap Open Enrollment Period.
In Kentucky, you can choose from 10 Medigap policies. Two of these plans are also available with high-deductible options.
Original Medicare, which is Medicare Part A and Part B combined, covers many of your healthcare expenses. But Original Medicare doesn’t cover everything, and you’ll still be responsible for costs like copayments and deductibles.1 If you frequently use healthcare, those expenses can add up throughout the year.
A Medigap policy, also called a Medicare Supplement plan, provides additional coverage to help cover some of those extra fees. Your Original Medicare will pay for its portion of your healthcare costs, then your Medigap policy will contribute toward the remaining expenses. This can reduce or even eliminate your out-of-pocket costs.
When Can You Enroll in Medigap?
It’s easiest to enroll in Medigap during your Open Enrollment Period. This six-month period automatically starts the month you turn 65 and are enrolled in Medicare Part B.2 During your Open Enrollment Period, you can buy any Medigap policy, even if you have a preexisting health condition like COPD.
You can still buy a Medigap policy after your Open Enrollment Period has ended, but it becomes more complicated. Outside of your Open Enrollment Period, insurance companies can deny you coverage if you have a preexisting condition. Companies can also exclude that condition, or can implement a six-month waiting period before your coverage starts.
If you have guaranteed issue rights, you can change or enroll in Medigap outside of your Open Enrollment Period without those restrictions.3 With guaranteed issue rights, insurance companies must let you buy a policy, and they can’t deny you coverage for preexisting conditions or increase your policy cost. Certain events, like moving outside of your current Medicare Advantage plan’s service area, can qualify you for guaranteed issue rights.
Alternatively, events like losing your current insurance might qualify you for a Special Enrollment Period.4 The changes you can make to your coverage during a Special Enrollment Period will depend on your type of qualifying event.
A Word of Advice
Your Medicare Open Enrollment period starts the month you turn 65 and lasts for 6 months. You’ll want to opt for a Medigap policy during this time for the greatest flexibility.
What Are the Most Popular Medicare Supplement Plans?
Plan Type | Total Enrolled (Rounded) | Percent of Total Enrolled |
Plan F | 123,000 | 53% |
Plan G | 58,000 | 25% |
Plan N | 23,000 | 10% |
In Kentucky, you can choose from 10 Medigap plans.5 Plan F and Plan G also have high-deductible options. While coverage varies from one plan to another, Plans F, G, and N tend to be popular. However, it’s important to review each plan’s coverage to find the best plan for your needs. Note: Plan F is not available if you are eligible for Medicare after January 1, 2020.
Plan F
Plan F offers the most comprehensive coverage and includes:
- Part A coinsurance and hospital costs
- Part B copays/coinsurance
- Blood (first 3 pints)
- Part A hospice
- Skilled nursing facility
- Part A deductible
- Part B deductible
- Part B excess charges
- Foreign travel emergency – 80%
Plan G
Plan G offers the same coverage as Plan F, minus the Part B deductible:
- Part A coinsurance and hospital costs
- Part B copays/coinsurance
- Blood (first 3 pints)
- Part A hospice
- Skilled nursing facility
- Part A deductible
- Part B excess charges
- Foreign travel emergency – 80%
Plan N
Plan N offers coverage similar to Plan F, but it excludes the Part B deductible and Part B excess charges:
- Part A coinsurance and hospital costs
- Part B copays/coinsurance
- Blood (first 3 pints)
- Part A hospice
- Skilled nursing facility
- Part A deductible
- Foreign travel emergency – 80%
How to Choose a Medicare Supplement Plan
Coverage varies between each Medigap plan. When choosing the plan that’s right for you, think about the types of healthcare expenses you have most often and look for a plan that covers those costs. You’ll also want to choose a plan with a premium that you can comfortably afford. You can use a third-party comparison tool like MedicareGuide.com to easily see the differences between policies.
A Word of Advice
The most popular plans might not necessarily be the best for you. Consider your most common healthcare expenses and look for a plan that covers those costs.
How Much Do Medigap Policies Cost?
Every Medigap plan varies in both cost and coverage. The following prices reflect quotes for both a 65-year-old female and male nonsmoker in Kentucky.
65-Year-Old Woman, No Tobacco Use
Plan Type | Premium Range |
Plan F | $112-$444 |
Plan G | $97-$355 |
Plan N | $73-$310 |
65-Year-Old Man, No Tobacco Use
Plan Type | Premium Range |
Plan F | $129-$510 |
Plan G | $111-$406 |
Plan N | $83-$351 |
What Companies Sell Medigap in Kentucky?
What If You Want to Change Your Medigap Policy?
Outside of your Open Enrollment Period, guaranteed issue rights, or Special Enrollment Period, your opportunities to change your Medigap policy are limited. It’s important to carefully research each policy and choose the plan that’s right for your needs so that you won’t have to try changing it later.
What Are Alternatives to Medicare Supplement?
A Medicare Advantage plan might be a good option if a Medigap policy isn’t right for you. Medicare Advantage plans help to cover some of the costs you’re responsible for with Medicare Part A and Part B.6 Some of these plans even offer prescription expense coverage.
What Are Medicare Resources in Kentucky?
- The Kentucky State Health Insurance Assistance Program (SHIP) provides free counseling and assistance to help you understand and make the best choices about your healthcare.
- The Kentucky Department of Insurance helps to educate the public about available insurance in the state. This department also handles consumer complaints about insurance companies.
- The Kentucky Department for Medicaid Services provides information about Medicaid and can help you to apply for the program.
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Next Steps
Medicare covers many of your healthcare costs, but you’ll still have out-of-pocket expenses that can add up. With the right Medigap policy, you can reduce or eliminate those costs. To learn more, check out How to Choose a Medicare Supplement Plan.