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Why You Should Consider Switching to a MedSupp Plan?

Writer's picture: Ashlynn MooreAshlynn Moore

Switching to a Medicare Supplement plan (MedSupp), also known as MediGap, can be a significant decision, especially when it comes to managing healthcare costs and coverage. Here’s a closer look at why it might make sense to consider switching to a MedSupp plan, as well as some factors to keep in mind.

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What is a Medicare Supplement Plan?

A Medicare Supplement plan, often called Medigap, is a type of insurance that helps cover certain out-of-pocket costs not covered by Original Medicare, such as copayments, coinsurance, and deductibles. Unlike Medicare Advantage plans, which offer an alternative way to receive Medicare benefits, MedSupp plans work alongside Original Medicare to fill the “gaps” in coverage.


Why Consider Switching to a MedSupp Plan?

  • Better Predictability of Costs: MedSupp plans can provide more predictability when it comes to healthcare costs. Unlike Medicare Advantage plans, which may have varying copays or coinsurance amounts for different services, MedSupp plans often come with a fixed monthly premium, covering most or all of the costs not paid by Original Medicare. This can be especially helpful if you have frequent doctor visits or require ongoing treatment.

  • Freedom to Choose Providers: With a MedSupp plan, you typically have the freedom to choose any healthcare provider that accepts Medicare. This can be a significant advantage if you travel frequently or want access to a broader network of specialists. It contrasts with some Medicare Advantage plans, which may restrict you to a specific network of doctors and hospitals.

  • Minimal Referrals Needed: Most MedSupp plans don’t require referrals to see a specialist, making it easier to manage your healthcare without navigating a network's rules. This can save time and simplify access to the care you need, which is important if you have ongoing health conditions requiring specialized care.

  • Comprehensive Coverage Options: MedSupp plans range from basic to more comprehensive options, allowing you to find a plan that fits your coverage needs. This flexibility makes it easier to match your healthcare needs and budget. For example, a Plan G may cover everything except the Medicare Part B deductible, while Plan N offers lower premiums but may require some copayments for office visits.


When Might It Be Time to Switch?

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  • You’re Facing High Out-of-Pocket Costs: If you have a Medicare Advantage plan but find yourself regularly paying high copays, coinsurance, or out-of-pocket maximums, switching to a MedSupp plan could potentially lower your costs. MedSupp plans may offer more predictability, especially if you frequently use medical services.

  • Your Health Situation Has Changed: A shift in your health, such as a new diagnosis or the need for more frequent medical care, might make a MedSupp plan a better fit. These plans can provide greater peace of mind knowing that unexpected expenses are more likely to be covered.

  • You Want More Flexibility with Providers: If your current plan restricts your choice of doctors or hospitals, a MedSupp plan could offer more freedom. This is particularly beneficial if you want to receive care outside your local area, such as when traveling within the United States.


Considerations Before Switching

  • Monthly Premiums: While MedSupp plans can help reduce out-of-pocket costs, they generally come with a higher monthly premium compared to many Medicare Advantage plans. It’s important to evaluate whether the additional monthly premium is affordable and makes sense for your budget.

  • Medical Underwriting: Depending on your state and when you apply, switching to a MedSupp plan may involve medical underwriting. This means the insurance company can evaluate your health history and could deny you coverage or charge a higher premium based on your health conditions. However, there are situations when you have guaranteed issue rights, such as during the MedSupp Open Enrollment Period or if you’re leaving a Medicare Advantage plan during certain times of the year.

  • Coverage Differences: MedSupp plans don't cover prescription drugs, so if you decide to switch, you will need a separate Medicare Part D plan to cover your medications. Consider how this will impact your overall costs and whether you can find a suitable Part D plan.

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  • Timing is Key: The best time to switch is during your MedSupp Open Enrollment Period, which begins when you are 65 or older and enrolled in Medicare Part B. During this time, you have guaranteed issue rights, meaning you cannot be denied a MedSupp policy or charged more due to pre-existing conditions. Outside this period, switching can be more challenging.


Switching to a Medicare Supplement plan can offer many benefits, such as lower out-of-pocket costs, more flexibility with providers, and predictable expenses. However, it’s not the right choice for everyone. Weighing the pros and cons, considering your current health status and financial situation, and timing your switch appropriately are crucial steps in making an informed decision.

Before making a switch, it's always advisable to consult with a Lion's Pride Insurance agent who can help evaluate your options and guide you based on your unique needs.

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