Questions · Supplement (Medigap)
Supplement (Medigap) Medicare questions
These answers explain the Medigap decision points in plain language, without naming companies or steering to a product.
Which supplement (medigap) questions should you start with?
Can I keep my Medigap plan if I move to another state?
Usually yes. Medigap plans work with Original Medicare, which is accepted nationwide, so your coverage generally moves with you when you relocate to another state.
What is Plan N and how does it compare to Plan G?
Plan N is a Medigap supplement plan that covers most of the same costs as Plan G but requires small copays at the doctor and emergency room, and it does not cover excess charges. In exchange, monthly premiums are typically lower than Plan G.
What are the biggest regrets people have with Medicare Advantage versus Medigap?
Medicare Advantage regrets often center on surprise costs and network restrictions when health needs increase. Medigap regrets usually come down to higher monthly premiums that felt unnecessary during healthy years.
Will I be able to keep my current doctors with Medicare?
It depends on which Medicare path you choose. Original Medicare gives you the most flexibility with providers nationwide. Medicare Advantage plans use networks, so keeping your current doctors depends on whether they participate in the plan you pick.
Can I see any doctor or specialist with Original Medicare plus a Medigap plan?
Generally yes. Original Medicare combined with a Medigap plan gives you broad access to any doctor or specialist who accepts Medicare, with no network restrictions.
What is coinsurance in Medicare and how is it different from a copay?
Coinsurance is your share of a medical cost expressed as a percentage, while a copay is a fixed dollar amount. Both are types of cost-sharing in Medicare, but they work differently depending on the service.
Does Medicare cover outpatient surgery and physical therapy?
Yes, Medicare covers outpatient surgery and physical therapy under Part B. You typically pay 20% of the Medicare-approved cost after meeting your deductible.
Does Part B cover durable medical equipment?
Yes, Part B covers durable medical equipment, often called DME, when a doctor orders it as medically necessary. You typically pay 20 percent of the Medicare-approved amount after your Part B deductible.
What Part A coinsurance costs apply after certain hospital days?
Original Medicare Part A covers hospital stays fully for the first 60 days after you meet the deductible. After that, you pay a daily coinsurance amount. Costs increase significantly after day 90. Exact amounts change each year.
What happens if I take COBRA instead of Medicare?
Taking COBRA instead of Medicare when you turn 65 is usually a costly mistake. COBRA is not considered creditable coverage for Medicare purposes, and you could face permanent late enrollment penalties.
Which Medicare option gives me the most freedom to choose my own doctors?
Original Medicare (Parts A and B) gives you the most flexibility. It's accepted by nearly any doctor or hospital in the country that takes Medicare, with no referrals required.
Which Medicare option is safer if my health changes suddenly?
Original Medicare with a Medigap supplement gives you the most flexibility if your health changes suddenly, since it has no network restrictions and you can see any Medicare-accepting provider without referrals.
What if my health could change in the next few years?
Health changes are one of the biggest reasons your Medicare plan choice matters. Picking a plan with flexibility now can protect you if your needs grow later.
What if I pick Medicare Advantage and later cannot get a supplement?
If you later want to switch from Medicare Advantage to Original Medicare with a supplement, you may be denied coverage or charged higher premiums based on your health history, unless you qualify for a special guaranteed-issue right.
Can I see doctors in two states if I have Original Medicare plus Medigap?
Yes. Original Medicare works nationwide, and most Medigap plans cover you anywhere a doctor accepts Medicare, regardless of which state you're in.
How do I compare a high-premium supplement to a low-premium Medicare Advantage plan?
Compare them by estimating what you'd actually spend in a full year under each option, including premiums, copays, and deductibles, not just the monthly cost difference. The right choice depends on how much healthcare you use.
Does Original Medicare have a maximum out-of-pocket limit?
Original Medicare does not have a maximum out-of-pocket limit, which means your costs could keep growing if you have a serious illness or long hospital stay.
What would my costs look like if I needed surgery or chemo on Medicare?
Surgery and chemotherapy can cost thousands under Medicare, depending on whether you have Original Medicare alone, a supplement, or a Medicare Advantage plan with an out-of-pocket maximum.
What is MOOP and why does it matter for Medicare?
MOOP stands for Maximum Out-of-Pocket. It is the most you would have to pay in a calendar year for covered medical services under a Medicare Advantage plan, after which the plan pays 100% of covered costs for the rest of the year.
What is the Part A deductible?
The Medicare Part A deductible applies each time you are admitted to the hospital for a new benefit period. It is not an annual deductible. The amount changes each year, so check the current figure at Medicare.gov or with a licensed agent.
What is the Part B deductible?
The Medicare Part B deductible is the amount you pay each calendar year before Medicare starts covering your outpatient medical costs. It resets every January 1 and the amount adjusts annually.
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