РусскийMedicare Doesn’t Cover Everything: How to Protect Yourself from Huge Medical Bills
If you think Medicare will cover all your healthcare costs, unfortunately, that’s not the case. Original Medicare (Parts A and B) has significant financial gaps that could leave you paying thousands of dollars out of pocket. This article explains how Medicare Supplement (Medigap) plans can protect your health and your budget.
What Doesn’t Original Medicare Cover? The Gaps in Part A & B
Before discussing solutions, it’s crucial to understand the problem.
- Part A (Hospital Insurance): Has a $1,600 deductible (for 2025) for each hospital benefit period. If you are hospitalized twice more than 60 days apart, you pay this deductible again.
- Part B (Medical Insurance): Has a small $257 deductible, but the main risk is the 20% co-insurance with no annual limit. This means you pay 20% of the approved amount for most services. For a $100,000 bill, that’s $20,000; for a $500,000 bill, it’s $100,000.
Medicare Supplement (Medigap): Your Financial Safety Net
Medicare Supplement plans are standardized insurance plans regulated by the government. Their primary purpose is to fill the “gaps” in Original Medicare coverage.
What Does Medigap Cover?
- Part A hospital deductible
- Part A and B co-insurance
- First 3 pints of blood
- Foreign travel emergency care (up to 80%)
For example, the most comprehensive popular plan, Plan G, covers everything except the Part B deductible ($257 in 2025). Once you pay that, you have $0 out-of-pocket costs for Medicare-covered services for the rest of the year.
Comparing Popular Plans: G vs. N
- Plan G: Best coverage. Zero out-of-pocket costs after the Part B deductible. Ideal for those who want maximum predictability.
- Plan N: Lower monthly premium. But has small copays: up to $20 for office visits and up to $50 for emergency room (ER) visits if you’re not admitted.
Who is Medicare Supplement Ideal For?
- People who value freedom of choice to see any doctor or specialist nationwide that accepts Medicare, without referrals.
- Those who want predictable costs: a fixed monthly premium instead of unexpected medical bills.
- Individuals with serious health conditions (cancer, diabetes, need for dialysis) for whom 20% co-insurance could be financially devastating.
- Frequent travelers (covers emergencies abroad).
Important Nuances and Limitations
- Doesn’t cover drugs: You need a separate Part D plan.
- No extra benefits: Does not typically include dental, vision, hearing aids (unlike many Medicare Advantage plans).
- Guaranteed Issue: The best time to enroll is during your 6-month Medigap Open Enrollment Period when you first get Part B. After this, in most states, you’ll face medical underwriting. Exceptions include states like New York.
Medicare Supplement vs. Medicare Advantage: Quick Comparison
| Feature | Medicare Supplement (Medigap) | Medicare Advantage (Part C) |
| Provider Choice | Any doctor accepting Medicare | Network providers (HMO, PPO) |
| Cost Predictability | High (fixed premium + deductible) | Variable (copays, coinsurance) |
| Extra Benefits (dental, etc.) | Rare | Often included |
| Foreign Travel Coverage | Yes (emergencies) | No (or very limited) |
Need Help Choosing a Plan? Consult with Experts!
Choosing between Plan G, N, and others, and navigating underwriting rules can be complex. Our agency, Chief Insurance Services, helps clients nationwide understand the details and find the most cost-effective Medicare Supplement plan for their needs.
A free consultation will help you:
- Compare prices from all insurance companies in your state.
- Understand if you can pass underwriting if your OEP has ended.
- Submit an application correctly and avoid mistakes.
Call us today at (616) 608-0444 for a personalized consultation. Protect your health and finances with the right plan!
Article based on materials from Veronika Raul, a licensed insurance broker.