If you’re enrolled in Original Medicare, you know that you’re not covered for everything. There are certain gaps in coverage that you’re responsible for even after Original Medicare has paid its share, such as cost sharing. Medicare Supplement (Medigap) plans in Maryland are designed to help Medicare beneficiaries pay for out-of-pocket expenses they may have in Original Medicare, Part A and Part B, including copayments, coinsurance, and deductibles. In addition, some plans may offer coverage for benefits beyond the federal program, such as emergency health coverage when you’re traveling outside of the country.
As a Medicare beneficiary in Maryland, you have access to a number of Medigap plans, depending on your zip code, so it’s a good idea to understand what Medigap in Maryland covers so you can choose a plan that best suits your needs.
How Medigap plans work in Maryland
There are 10 standardized Medicare Supplement plans available in 47 states, including Maryland. Each plan is identified by one of 10 letters (A, B, C, D, F, G, K, L, M, and N), with plans of the same letter offering the same benefits. Different types of standardized Medigap plans are available in three states: Massachusetts, Minnesota, and Wisconsin.
To enroll in Medigap in Maryland, you must already be enrolled in Original Medicare, Part A and Part B. Also, keep in mind that Medicare Supplement coverage pays for costs in Original Medicare, but can’t be used to cover out-of-pocket expenses with a Medicare Advantage plan.
Your Medigap Open Enrollment Period is generally the best time to enroll in a plan. This period starts the first day you are both age 65 or older and enrolled in Medicare Part B, and lasts for six months. During your Medigap Open Enrollment Period, you have special Medigap protections known as “guaranteed-issue rights.” Basically, this means you can enroll in any Medicare Supplement plan available in your area, offered by any insurance company of your choice. You can’t be denied coverage for pre-existing conditions or required to go through medical underwriting (although the insurance company may still make you wait up to six months before covering pre-existing conditions, even during this period). Note that there are generally no other enrollment periods besides your Medigap Open Enrollment Period, so you can enroll in or switch plans at any time of the year after this period has passed. However, once your Medigap Open Enrollment Period is over, you may not be able to enroll in a Medigap plan in Maryland with guaranteed issue. Without these special rights, there’s a chance you may be denied coverage or charged more for your choice of insurance plan. Insurance companies are also allowed to require medical underwriting.
Medigap in Maryland is meant to supplement Original Medicare, not replace it or provide stand-alone coverage. In other words, you have to stay enrolled in Original Medicare and keep paying your Medicare Part B premium if you want to keep your health insurance coverage and stay eligible for Medicare Supplement insurance. Also, since Medigap plans in Maryland do not offer prescription drug coverage, you may want to consider enrolling in a stand-alone Medicare Part D Prescription Drug Plan to receive prescription drug benefits.
Types of Medigap plans in Maryland
Take a look at the benefits you may receive under the 10 standardized Medicare Supplement plans available in Maryland. Please note that not every plan type is available in every location, and insurance companies that offer Medigap plans aren’t required to sell every plan. In this chart, X indicates that the service (or item) is 100% covered; a percentage indicates what percent of the service/item is covered; and a blank cell indicates it is not covered.
|Medicare Supplement Plans|
|Medicare Supplement Benefits||A||B||C||D||F*||G||K||L||M||N|
|Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted||X||X||X||X||X||X||X||X||X||X|
|Medicare Part B copayment or coinsurance||X||X||X||X||X||X||50%||75%||X||X***|
|First three pints of blood||X||X||X||X||X||X||50%||75%||X||X|
|Medicare Part A hospice care coinsurance or copayment||X||X||X||X||X||X||50%||75%||X||X|
|Skilled nursing facility care coinsurance||X||X||X||X||50%||75%||X||X|
|Medicare Part A deductible||X||X||X||X||X||50%||75%||50%||X|
|Medicare Part B deductible||X||X|
|Medicare Part B excess charges||X||X|
|Foreign travel emergency coverage (up to plan limits)||80%||80%||80%||80%||80%||80%|
|Out-of-pocket limits apply.**|
*Medicare Supplement Plan F offers a high-deductible version in which beneficiaries pay a certain deductible amount before the plan begins coverage. This amount may change from year to year.
**Once you reach the out-of-pocket limits (including the Part B deductible), both Medicare Supplement Plans K and L pay 100% of covered services in the above chart for the remainder of the calendar year.
***Medicare Supplement Plan N pays 100% of the Medicare Part B coinsurance, except for a copayment of up to $20 on doctor visits and up to $50 on emergency room visits that don’t result in an inpatient admission.
Choosing a Medigap plan in Maryland
As stated earlier, Medicare Supplement plans in Maryland with the same letter designation don’t vary in coverage or benefits. However, each independent insurance company that offers Medicare Supplement plans can determine its own monthly premium structure, and how the company prices its premiums can affect both your costs when you enroll in a plan and later on. This also means that if you live in Bethesda in Montgomery County you may pay more or less than a resident of Annapolis in Anne Arundel County for an identical Medicare Supplement plan. Considering the differences in costs, it may be a good idea to compare all Medicare Supplement plan options available in your area so you can choose a Medigap plan in Maryland that fits your individual health and budget requirements.
As you can tell, you may have various Medigap plan options available in Maryland. If you have frequent doctor visits or out-of-pocket costs, a Medicare Supplement plan may help lower your medical costs. Do you have questions or want help finding a plan that may fit your budget and health needs? Call the phone number on this page to reach a licensed insurance agent and get personalized assistance with Medicare plan options in your location.