What Is a NJ Medicare Supplement Plan?
Medicare plans have so many different names, it can be hard to tell them apart. This article will explain what New Jersey Medicare Supplement (or "Medigap") plans are, and help you understand whether these plans are a good fit for you.
What is the purpose of Medigap insurance?
Original Medicare is comprised of hospital insurance (Part A) and medical insurance (Part B). But Original Medicare doesn't cover all health care costs, which can add up to a lot.
Therefore, additional types of health plans are available through private insurance companies, including Medicare Advantage and Medigap plans. You can read more about the basics of Medicare here.
Medigap plans are designed to fill the "gaps" in what Original Medicare covers. They help pay some or all of the out-of-pocket costs you'd be responsible for paying if you only had Medicare Parts A and B. (You must already be enrolled in Medicare Parts A and B to get a Medigap plan.)
Medigap plans help cover things like copayments, coinsurance, and deductibles, which can still be quite high after Medicare pays its share.
Medicare supplement plans from AmeriHealth are called AmeriHealth Medigap.
What types of Medicare Supplement insurance are available in NJ?
The Centers for Medicare and Medicaid Services has defined 10 different types of Medigap plans, which are standardized across the United States. Their names are:
- Plan A
- Plan B
- Plan C*
- Plan D
- Plan F*†
- Plan G*†
- Plan K
- Plan L
- Plan M
- Plan N
*These plans aren't available to anyone who became newly eligible for Medicare on or after January 1, 2020.
†These plans also offer a high-deductible option in some states. With this option, you must pay a specific dollar amount in coinsurance, copayments, and deductibles before your policy pays anything.
Covered health care costs and premiums vary for each plan, and also vary depending on where you live, your age, and your gender. Not all plans are available in every state or service area, and not all plans are available from any particular insurance company.
AmeriHealth Medigap offers Plans A, D, G (with and without a high-deductible option), and N to new enrollees.
Medicare Supplement Plans and prescription drugs
Medigap plans do not include Medicare Part D prescription drug coverage. Therefore, if you enroll in a Medigap plan, you must also enroll in a separate prescription drug plan (PDP) in order to have these types of charges covered. And these costs can be very high.
What are the pros and cons of Medigap plans?
If you are shopping for a Medicare plan, you may be wondering if a Medicare Supplement plan is the right choice for you. Let's take a look at the advantages and disadvantages of a Medigap plan.
Advantages of a Medicare Supplement plan:
- Some Medigap plans help cover coinsurance and deductibles that you would still have to pay under Original Medicare, and these health care costs could otherwise be very high.
- Medigap plans typically have lower out-of-pocket costs than Medicare Advantage plans.
- Medigap plans covers services from any health care provider in the United States who accepts Medicare, whether they are in your health plan's network or not.
Disadvantages of a Medicare Supplement plan:
- Medigap plans typically have higher monthly premiums than Medicare Advantage plans.
- Medigap plans do not cover Part D prescription drug costs, so it's necessary to enroll in a Part D PDP separately.
- Unlike Medicare Advantage plans, Medigap plans do not include extras such as dental, vision, or hearing coverage.
Who would benefit most from Medicare Supplement coverage?
The ideal candidate for a Medigap plan:
- Enjoys the freedom to see any health care provider in the U.S. that accepts Medicare.
- Wants protection from the potentially very high costs of medical and hospital care.
- Doesn't want to worry about out-of-pocket costs of health care such as copays, coinsurance, and deductibles.
So, for example: Felix has a chronic health condition that requires a lot of medical care — with many doctor visits, diagnostic tests, and specialized procedures. The copays, coinsurance, and deductible costs could really add up.
Felix may end up paying less with a Medigap plan than a Medicare Advantage plan, even if the Medigap plan's premiums are higher than those of the Medicare Advantage plan. And because he knows how much his health care costs are going to be each month, it's easier for him to budget.
Josephine enjoys traveling and spends a lot of time touring the country in her Winnebago. She doesn't want to have to worry about what doctors she can or cannot see in any state or territory. Her Medigap plan gives her the peace of mind of knowing that her insurance will be accepted by all health care providers who take Medicare patients.
What about other Medicare options?
Medicare Advantage plans are available through Medicare-approved private insurance companies like AmeriHealth. They cover all the same benefits as Medicare Parts A and B, and may include Part D prescription drug coverage as well. They can also cover extras like hearing, dental, and vision care.
AmeriHealth offers PPO Medicare Advantage plans. With a PPO, you may see out-of-network providers, but you will usually spend less if you use an in-network provider. Medicare Advantage plans typically have lower monthly premiums than Medigap plans. Learn more about the differences between Medigap and Medicare Advantage plans.
Our plan comparison will provide you with some of the benefits offered as well as our plan premiums. If you've chosen a plan and you're ready to enroll, you've come to the right place!
Website last updated: 8/8/2023