7 Common Myths About Medicare Supplement Plans

Updated on June 27, 2021

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A Medicare Supplement plan (also referred to as a Medigap plan) is Medicare insurance meant to fill the coverage gaps left by Original Medicare Parts A and B. Medicare Supplement plans are relatively straightforward and easy to understand. Even better, there are Medicare Supplement plan reviews available online that can guide your decision.

Yet, like anything else, there are widespread myths and misconceptions on Medigap that regularly cause confusion. As a result, some people fail to take up a Medicare Supplement plan or opt for one that isn’t best-suited for them.

Myth 1: Medicare Supplement Plans and Medicare Advantage Plans are the Same Thing

You’ll be surprised by how many people place Medicare Supplement plans and Medicare Advantage plans in the same category. The two plans are markedly different. Medicare Supplement plans enhance, complete, and complement Original Medicare Part A and Part B. Medicare Advantage plans, on the other hand, replace Original Medicare cover. Another critical difference is Medicare Advantage has copays and out-of-pocket maximums, whereas Medicare Supplement plans don’t. Medicare Advantage is considered to be Original Medicare Part C as a primary insurance plan.

Myth 2: Medicare Supplement Plans Cover Prescription Drugs

Medicare Supplement plans are an addition to the coverage offered by Original Medicare Part A and Part B. The plans do not, however, provide prescription drug coverage. If you want your prescription medication covered, you have to enroll in Medicare Part D.

Myth 3: Changing Medicare Supplement Plans Can Only Occur During a Specific Time of the Year

You can change Medicare Supplement plans at any time of the year. What’s important to note is that insurance carriers may medically underwrite you and can decline your application based on the state of your health. If you are in relatively good health with no pre-existing conditions, changing plans should be a seamless process.

Myth 4: You Have to Go to a Doctor that Accepts the Medicare Supplement Plan You are On

There’s a common assumption that the doctor you see has to be contracted by your Medicare Supplement plan. This is not correct. As long as the doctor accepts Medicare payments, they are under obligation to accept your Medicare Supplement plan. A doctor cannot restrict themselves to accepting a specific Medigap plan. This flexibility is why Medicare Supplement plans appeal to individuals who want to be covered when they travel out of state. It also gives access to a broader pool of providers.

Myth 5: Medicare Supplement Plans Differ from Carrier to Carrier

Medicare Supplement plans are standardized and do not vary between carriers or states. This consistency is designed to protect consumers. For example, Medicare Supplement Plan F’s benefits will be the same at Cigna, Blue Shield, and Aetna. The difference is the premium each carrier will levy for the plan. While one may charge $180 per month, another may offer the same plan at $150.

Myth 6: It’s Best to Buy from the Largest Carrier

When it comes to financial services such as medical insurance, there’s a strongly held view that the bigger the business, the better the terms. For this reason, people will drift towards the largest carrier when choosing Medicare Supplement plans. That’s not always the most prudent decision, though. 

The largest and best-known carriers will add a markup to the premium that’s commensurate with their outsized reputation. Plans are standardized, so there’s no need to pay more when you don’t have to. In other words, don’t base your choice on name recognition alone.

Myth 7: My Medicare Supplement Plan Will Cover My Spouse

Medicare Supplement plans are specific to an individual. The benefits are not transferable to your spouse. If they want to be covered by a Medigap plan, they have to buy their own policy.

Choose the Most Suitable One for You

Seniors and any else eligible for Medicare will have many questions. There are many plans, and it won’t always be obvious which one is most suitable for you. Take time to evaluate the different plans, so you find the one that’s best for you.

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