Medicare Supplement

Medigap in Greenwood: how the letter plans fit Original Medicare

GREENWOOD, S.C. — If you've ever tried to read a Medicare Supplement brochure and felt your eyes glaze over at all the letters — Plan A, Plan G, Plan N — you're not alone. Medicare Supplement insurance, better known as Medigap, is one of the most misunderstood parts of Medicare. It doesn't replace Original Medicare, and it doesn't add drug coverage. What it does is help pay the out-of-pocket costs Original Medicare leaves behind.

Here in Greenwood, where many neighbors are weighing their choices around age 65 or a job change, understanding how Medigap works — and what those standardized letters mean — can help you avoid an expensive mistake later.

What Medigap actually does

Original Medicare pays a large share of your hospital and doctor bills, but not all of it. You still owe the Part A hospital deductible, the Part B deductible, and generally 20% of the cost of most outpatient services — with no yearly cap on what you could spend.

Medigap is private insurance you can buy to help pay those leftover costs. Depending on which lettered plan you choose, it can cover things like:

• Part A hospital coinsurance and extra hospital days after Medicare's benefits run out
• Part B coinsurance or copays
• The first three pints of blood
• Skilled nursing facility coinsurance
• Part A hospice coinsurance
• The Part A deductible (and, in some plans, the Part B deductible)
• Limited foreign travel emergency care

You pay a monthly premium to the insurance company on top of your Part B premium. In return, your share of medical bills gets simpler and more predictable.

How the standardized letters work

This is the part that trips people up. Medigap plans sold today are labeled with letters: A, B, C, D, F, G, K, L, M, and N. In most states, those benefits are standardized by federal rules. That means a Plan G sold by one company in Greenwood covers exactly the same core benefits as a Plan G sold by any other company here — the difference is the price and the customer service.

A few important notes:

• Plans C and F, which cover the Part B deductible, are no longer available to people who became eligible for Medicare on or after January 1, 2020. If you were eligible before that date, you may still be able to buy them.
• Plans K and L have lower premiums but include an out-of-pocket limit and cost-sharing on some services.
• Plan N has slightly lower premiums than Plan G but includes small copays for some office and emergency room visits.

Because the benefits are set by the letter, comparing plans really comes down to comparing the same letter across carriers.

What Medigap does NOT cover

This is where mistakes happen. Medigap does not include:

• Prescription drugs — you need a separate Part D plan for that
• Dental, vision, or hearing care
• Long-term care (nursing home stays for custodial care)
• Hearing aids
• Private-duty nursing

And you cannot use Medigap with a Medicare Advantage plan. It's designed to pair with Original Medicare only. If you're enrolled in Advantage and want to switch to Original Medicare plus a Medigap policy, there are specific rules and windows to know about before you make that move.

Timing matters — the 6-month window

The single most important date in the Medigap world is the start of your Medigap Open Enrollment Period. It begins the month you're 65 or older and enrolled in Part B, and it lasts six months.

During that window, insurance companies must sell you any Medigap policy they offer at the best available rate, regardless of your health history. Outside that window, in most cases, carriers can use medical underwriting — meaning they can charge you more or turn you down based on your health. South Carolina does not have a state law giving broader guaranteed-issue rights, so this federal window is the one to protect.

There are also limited "guaranteed issue" rights in certain situations, like losing other coverage. If you're not sure whether one applies to you, call your local SHIP counselor before you cancel anything.

How Greenwood fits in

Greenwood is in Greenwood County, and Medicare plan availability — including how many Medicare Advantage and Part D plans are offered — is set at the county level. Medigap works a little differently: because the benefits are federally standardized, the same lettered plans are broadly available, though the specific carriers and prices vary. You can compare Medigap policies sold in your ZIP code using the plan finder at medicare.gov.