Original MedicareOriginal Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). covers 80% of most covered services, leaving you with a 20% “gap” in coverage.
Tennessee Medigap plans help you cover your out-of-pocket costs, such as copayments, coinsurance and deductiblesA deductible is an amount you pay out of pocket before your insurance company covers its portion of your medical bills. For example: If your deductible is $1,000, your insurance company will not cover any costs until you pay the first $1,000 yourself..
If you’re enrolled in Original Medicare, you are eligible for a Medicare Supplement Plan.
There are 12 Medigap plans available in Tennessee, giving you a range of cost and coverage options.
Medicare in Tennessee provides health insurance to adults over 65, as well as younger adults living with a disability or chronic health condition. Original Medicare covers hospital care (Medicare Part A) and medical care (Medicare Part B). But Original Medicare doesn’t cover all your healthcare expenses. Each time you see the doctor or access a covered service, Original Medicare covers 80% of the cost. The remaining 20% is your coinsurance, and you’ll pay this expense whenever you access care. For some services you may have a copayment, where you pay a fixed cost rather than a percentage of the bill.
Your out-of-pocket costs can include:
- Part A and Part B yearly deductibles
- Part A and Part B monthly premiums
- Part B excess charges
There is no limit on out-of-pocket costs for Original Medicare, so you will continue to pay these expenses throughout the whole year.
Find a local Medicare plan that fits your needs
You can lower your Original Medicare out-of-pocket costs by purchasing a Medicare Supplement Plan. These policies, also called Medigap plans, can help you pay your coinsurance, copayments and deductibles. This fills in your “gaps” in coverage and can reduce your overall healthcare costs.
All Tennessee Medigap plans will cover:
- Medicare Part A coinsurance for hospital and hospice care
- Medicare Part B coinsurance and copayments
- Blood needed for medical procedures (first 3 pints in a year)
Some TN Medigap plans will also cover:
- Part A coinsurance for skilled nursing care facility
- Part A deductible
- Part B excess charges
- Up to 80% of foreign travel emergency healthcare
Insurance companies offer 12 Medigap policies in Tennessee. Each company sets its own prices, but coverage stays the same. This means that if you purchase a Medigap Plan G in Tennessee, your coverage will be the same regardless of your plan provider. You can see exactly what’s covered in each plan by using this side-by-side comparison chart. It shows the 10 regular policies and the two high-deductible Medigap policies.
Each Medigap plan offers different coverage, so costs vary significantly. Not only that, but each health insurance company can set its own rate. Your Medigap premiums can be based on your age, gender, health status, when you buy the policy and where you live. Tennessee Medicare Supplement Plan premiums range from $22 to $1,641 in 2022.
Are you eligible for cost-saving Medicare subsidies?
You’re eligible for a Medicare Supplement Plan in Tennessee as soon as you’re enrolled in Original Medicare Part A and Part B. You can buy a Medigap policy when your Medicare Part B coverage starts.
When is the best time to enroll in Medigap?
You can purchase a Medicare Supplement Plan at any time, but the best time to enroll is during your Medigap Open Enrollment Period. This is a six-month period that starts the day your Medicare Part B coverage begins. In the Open Enrollment Period, insurance providers must sell you any Medigap plan you choose. You’ll have guaranteed issue rights, and you will not be denied coverage. During this period, plan providers cannot use your health status to increase your premiums, so you’ll be able to purchase your plan at the best price.
If you choose to enroll in Medigap after your Open Enrollment Period, insurance providers may take a closer look at your medical history or use medical underwriting to increase your costs. They can even deny your application.
Medigap plans in Tennessee do not include prescription drug coverage. Medigap plans help you fill in the gaps in your Original Medicare coverage, but they do not add benefits or cover medication costs.
If you want prescription drug coverage, you can enroll in Medicare Part D. This plan covers prescription medications, and it has associated out-of-pocket costs such as deductibles, premiums and copayments. Medigap plans do not cover any Medicare Part D costs.
What extra benefits and savings do you qualify for?
Medigap and Medicare Advantage are two popular plans that help cover healthcare costs. Medicare Advantage plans offer a range of benefits, starting with all the same coverage as Original Medicare Part A and Part B. Coverage may also include dental services, vision services, over-the-counter products and prescription drug coverage. If you enroll in a Medicare Advantage plan, you’ll need to pay monthly premiums, a yearly deductible and copayments or coinsurance.
Medigap plans do not include additional benefits. Instead, these plans help you fill in the gaps in Original Medicare. They can cover out-of-pocket costs like deductibles and coinsurance, lowering your costs each time you access covered services. Medigap plans do not cover any costs for Medicare Advantage plans and you cannot have both plans at the same time.
Medicare Supplement Plans only cover one person. Your spouse is not covered by your Medigap plan. If your spouse needs Medigap coverage, they can apply for their own plan. During their Medigap Open Enrollment Period, they can select the best Medigap plan for their healthcare needs and budget.
All 12 Medigap policies are available in Tennessee. However, you may not be eligible for all plans. If you became eligible for Medicare after January 1, 2020, you cannot buy Medigap Plan C or Plan F. If you became eligible for Medicare before January 1, 2020, you may be able to purchase these plans.
Not all plans are available everywhere in the state. Before you compare plans, look up which plans are available in your area.
If you’re enrolled in Original Medicare Part A and Part B, you can buy a Medigap plan. You’ll have an Open Enrollment Period when your Medicare Part B coverage starts, regardless of your age. However, you may have fewer plan options and your premiums may be higher.
When you turn 65, you will have a second Medigap Open Enrollment Period with guaranteed issue rights. You’ll be able to enroll in any Medigap plan in your area and you may find a plan with lower premiums or increased coverage options.
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement