Proper health care should never be a luxury. Unfortunately, some older adults struggle to pay for medical costs. Medicare supplement plans, also known as Medigap, are designed to fill in the gaps Original Medicare doesn’t cover. You may experience sticker shock, as some Medigap plans cost hundreds of dollars each month. The good news is not all plans will break the bank! There are budget-friendly options, as well as federal and state cost assistance programs, to help ensure your health and wellbeing remain a priority.
Which Medigap Plans Are the Most Affordable for Low-Income Seniors?
Before we take a deep dive into the specifics of our top carriers, below is a highlight of some of the most popular Medigap plans for older adults on a limited income.
High-deductible and cost-sharing Medigap plans are popular with low-income older adults, as these options have lower monthly premiums. Keep in mind, while these Medigap plans cost less each month, the deductibles, copayments, and coinsurance not paid by Medicare can add up, especially if you have a chronic illness or other medical condition.
As you research the best Medigap plan to meet your health care needs (without putting a strain on your finances), take time to explore these plans with lower premiums:
- High-Deductible Plan G
- Plan K
- Plan L
- Plan N
*High-Deductible Plan F is another plan with a low premium. However, it is not available to new beneficiaries who became eligible for Medicare on or after January 1, 2020.
How We Chose the Best Medigap Plans for Low-Income Seniors
We evaluated 12 of the top Medigap carriers using the following criteria: Medigap plans offered with a low monthly premium, budget-saving discounts, perks, and insurance company expertise in the Medicare arena. From our research, we narrowed the list to our top picks. We also investigated if the insurer’s website offered easy access to plan costs and availability.
How Much Does Medigap Cost?
While Medigap plan coverage is federally mandated to be the same across all insurance companies, policy pricing is not. This is because your Medigap policy is purchased through a private insurance company. The bottom line? There can be a big difference in insurance company plan premiums for identical coverage.
How Are Medigap Plans Priced?
Insurance companies can price Medigap policies in three different ways (known as the plan This is essential to keep in mind as you review Medigap insurance carriers. What appears to be the most cost-effective plan could end up putting a major financial strain on your wallet. As you shop for a budget-friendly Medigap plan, ask each insurance company how they rate their policies.
With attained-age Medigap policies, your age at the time of enrollment determines your premium. Premiums are lower for “younger” older adults and increase as you age. In addition to age increase, inflation will affect attained-age policies.
Your age isn’t a factor for community-rated Medigap policies. At this time, eight states require premiums to be community-rated among policyholders ages 65 and older:
- New York
This means that Medigap insurers cannot charge higher premiums to people because they are older or have more health conditions. Therefore, they must charge an 80-year-old policyholder the same as a 70-year-old policyholder regardless of health The remaining 38 states and the District of Columbia have the option to offer community-rated premiums, but most don’t.
Did You Know? Every Medigap policy must follow federal and state laws designed to protect you, and it must be clearly identified as “Medicare Supplement Insurance.” Insurance companies can sell you only a standardized policy identified in most states by
Issue-age Medigap policies are unique, as the premium is locked in at the time you purchase the policy. As with attained-age and community-rated Medigap policies, the younger your age during enrollment, the lower your premium. However, the difference with issue-age Medigap plans is the premium won’t change as you age.
Seven Factors That Affect Medigap Pricing
It’s federally mandated that what’s included in each Medigap plan is the same across all insurance companies. For example, Plan N at one company is identical to Plan N at another. However, since Medigap is sold through private insurance companies, the carriers dictate their pricing (premiums), discounts offered, and annual increases.
Medigap pricing can be affected by factors such as:
- How the policy is rated (attained-age, community-rated, or issue-age rated)
- Your age at enrollment
- Your gender
- The state/ZIP code where you reside
- Marital status
- If you are a smoker
- If you are enrolling after your six-month Medigap open enrollment window has passed
Tip from the Experts: It’s important to remember if you enroll after your six-month open enrollment period, insurance companies can charge you a late penalty, higher rates, or deny coverage. If you’re planning on enrolling in a Medigap policy, don’t wait!
Medigap Plan Pricing Comparison
Let’s compare policy prices for one Medigap plan from various carriers to give you a better idea of how pricing varies. The prices below are based on a 65-year-old nonsmoking female (born January 1, 1957) electing Medicare Part A and B, along with Medigap Part N coverage beginning August 2022.
|Medigap insurance company
||Mercer, NJ (08690)
||Polk, IA (50317)
||San Francisco, CA (94111)
|Mutual of Omaha
It’s important to note the websites for the insurance carriers listed in the above table provided quotes that included discounts. This can be misleading, as not everyone will be eligible for discounts, so make sure you are indeed eligible for the discount and can take advantage of it.
- Mutual of Omaha provides quotes factoring in a household discount up to 12 percent, which varies by state. For example, the discount in New Jersey is seven percent.
- AARP offers a significant enrollment discount of up to 39 percent.
- Humana’s pricing is at a preferred rate, with an online application discount included.
- Cigna offers premium discounts of up to 25 percent for qualified applicants. However, the premium discount is not available in Hawaii, Idaho, Minnesota, and Vermont.
Always remember, a quote is an estimate, and pricing can change once you complete the actual Medigap application.
Other Ways to Save on Health Care for Low-Income Seniors
Many older adults struggle to pay for adequate health coverage. Medicaid is a federal-state assistance program that provides health coverage to 7.2 million low-income seniors enrolled in Medicare. Medicaid covers medical costs that Medicare does not (such as hospice or long-term care). It also covers your out-of-pocket Medicare costs.
Qualification for Medicaid is based on several factors, such as:
- Income and assets
- Household size
- Family status
Medicaid guidelines, qualifying factors such as income limits, and coverage vary by state. To determine if you are eligible for your state’s Medicaid program, submit the enrollment application directly to your state Medicaid agency or through Healthcare.gov’s Health Insurance Marketplace.
Medicare Cost Assistance Programs
Medicaid isn’t the only option for individuals on a limited income. There are several federal and state programs in place to help lower or eliminate your out-of-pocket Medicare costs.
Keep in mind, the Medicare assistance programs listed below all vary by state. For more information, contact your State Health Insurance Assistance Program (SHIP) for guidance.
- Medicare Savings Programs (MSPs): Low-income individuals may qualify for a Medicare Savings Program. The type of Medicare assistance you may receive depends on income and asset limits. For example, if you fall under the Qualified Medicare Beneficiary (QMB) guidelines, the Medicare Savings Program will pay Part A and B premiums and eliminate cost-sharing for Medicare-covered services.
- Extra Help: Extra Help is a federal program that helps pay the out-of-pocket costs of your Medicare Part D prescription drug coverage. This includes paying for your Part D plan premium and reducing the cost of your prescription drugs. To receive Extra Help, you must be enrolled in a Medicare Part D prescription drug plan.
- State Pharmaceutical Assistance Programs (SPAPs): SPAPs are state-run programs to help residents pay for prescription drugs. Benefits may include paying for your Part D premium, copayments, or deductibles.
- Government-Funded Health Centers: Government-Funded Health Centers, also known as HRSA Health Centers or Federally Qualified Health Centers, offer reduced-cost medical care across the United States to those in need.
Did You Know? Less than half the people eligible for Extra Help actually sign up. Don’t automatically rule out this option; apply to find out if you qualify.