Medicare Supplement Plans in Vermont

What Are Medicare Supplement Plans in Vermont?

Medicare is a federal health insurance program for individuals aged 65 and older, as well as younger people with qualifying disabilities or health conditions (e.g., end-stage renal disease).

Original Medicare, which includes Part A (Hospital Insurance) and Part B (Medical Insurance), covers many healthcare services. However, it still leaves you with out-of-pocket costs like deductibles, coinsurance, and copayments. Medicare Supplement plans help pay for these expenses.

Medigap plans are standardized by letter (A through N). That means Plan A from one company offers the same benefits as Plan A from another, though premiums may differ.

Learn how these plans work and how they benefit residents of Vermont.

When Can You Enroll in a Medicare Supplement (Medigap) Policy?

You can apply for a Medigap plan at any time. However, outside of your Medigap Open Enrollment Period—or without guaranteed issue rights—insurers may use your health history to deny coverage or charge higher premiums.

Your Medigap Open Enrollment Period lasts for six months. It begins the month you are both 65 or older and enrolled in Medicare Part B. During this time, insurers must offer you any plan they sell at standard rates, regardless of your health.

This is the ideal time to enroll because it gives you the broadest choice of plans and the best pricing.

Guaranteed issue rights apply in specific situations—such as when you lose other health coverage or move out of your Medicare Advantage plan’s service area. If you qualify, insurers must offer you a policy and cannot charge more or delay coverage due to your health.

Unlimited Open Enrollment: Medicare supplement plans are community-rated and available year-round without underwriting. All plans are guaranteed issue, though higher rates may apply for those under 65, and coverage can be denied for individuals with ESRD.

What Are the Most Popular Medicare Supplement Plans?

Nationwide, and in Vermont, the most common Medigap plans include:

• Plan F: Offers the most comprehensive coverage, but is only available to individuals who were eligible for Medicare before January 1, 2020.
• Plan G: Covers nearly everything Plan F does, except the Medicare Part B deductible.
• Plan N: Covers many core benefits, but you may have copayments for certain doctor and emergency room visits, and it does not cover Part B excess charges.

How Do You Choose a Medicare Supplement Plan?

To choose the right Medigap plan in Vermont:

• Select a plan letter based on your healthcare needs and budget.
• Compare the same plan letter (e.g., Plan G) from multiple insurers—coverage is identical, but pricing can vary.
• Understand how insurers set premiums using one of the following methods:
  • Attained age rating – Premiums increase as you age.
  • Issue age rating – Premiums are based on the age you are when you enroll and don’t increase due to age.
  • Community rating – Everyone pays the same premium, regardless of age.

Always compare “apples to apples”—for example, Plan G from one insurer versus Plan G from another. For extra help, you can consult a licensed insurance agent.

How Much Do Medigap Policies Cost?

Medigap premiums in Vermont vary based on:

• Your age and gender
• Whether you use tobacco
• The plan you choose
• The pricing method used by the insurer

What If You Want to Change Your Medicare Supplement Plan?

You can apply to change Medigap plans at any time. However, unless you qualify for guaranteed issue rights, insurers may review your health history, which could result in denial of coverage or higher premiums.

If you are switching plans, be sure to cancel your existing policy only after you’ve been approved for the new one.

What Are Alternatives to Medicare Supplement Plans?

Medicare Advantage plans, also called Part C, are offered by private insurance companies approved by Medicare. These plans include Part A (hospital) and Part B (medical) coverage, and most include Part D (prescription drug coverage).

They often provide extra benefits such as dental, vision, hearing, and wellness programs. Instead of purchasing both a Medigap and a separate drug plan, some people choose a Medicare Advantage plan for combined coverage.

Learn more about Vermont Medicare Advantage plans.

Medicare Part D?

Medicare Part D plans offer standalone prescription drug coverage.

• Who needs it: Anyone enrolled in Original Medicare who wants coverage for prescriptions.
• What it covers: Prescription medications; specific coverage depends on the plan.
• How it’s offered: Through private insurers approved by Medicare.
• Not needed if: You’re in a Medicare Advantage plan that already includes drug coverage (MAPD).

Do Medigap Plans Cover Prescription Drugs?

No. Medigap plans do not include prescription drug coverage. If you want drug coverage, you must enroll in a separate Medicare Part D plan.

Medicare Resources in Vermont

Residents of Vermont can access free Medicare support through these programs:

• State Health Insurance Assistance Program (SHIP) – Offers one-on-one Medicare counseling.
• Vermont Department of Financial Regulation – Insurance Division – Regulates Medigap insurers and provides consumer protection and complaint resolution.
• Green Mountain Care (Vermont Medicaid Program) – Provides health coverage for low-income individuals and may coordinate with Medicare.

Next Steps

If a Medicare Supplement plan in Vermont fits your healthcare and financial needs, compare plans available in your area to get started. You can browse options online or speak with a licensed insurance agent for expert support and guidance.