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July 29, 2021
Do Medicare Supplement Plans Have Copays?

Do Medicare Supplement Plans Have Copays?

After going through all the trouble of finding the right Medicare coverage for your needs, it can be challenging to receive a bill in the mail when life is already so expensive. That’s right, we’re talking about copayments.

These pesky costs are an out-of-pocket payment that can haunt those who receive a lot of medical care. However, Medicare Supplement plans may be the answer to those copay worries. So, let’s get down to all things Medigap and copays.  

What are copays?

A copay, otherwise referred to as a “copayment,” is a fixed, out-of-pocket cost that you must pay after seeing a doctor or specialist or going to an urgent care facility or the emergency room. The exact amount of your copay will depend on which plan you choose.

It's that simple!

Does Medicare have copays?  

Not every part of Medicare has copayments, but every part will usually have some form of out-of-pocket cost, so it’s really all about what works for your needs.  

For example, Original Medicare does not have any copays, but you will have to pay for the 20% Part B coinsurance. So, if you have Original Medicare only, you will likely have costs to account for when receiving certain types of care.  

Additionally, Medicare Part D prescription drug plans may also have copays, but the amount will depend on your specific plan and which tier your drug is in.

Do Medicare Advantage plans have copays?  

Yes, Medicare Advantage plans have copays. Medicare Advantage plans have the same coverage as Part A and Part B, with added benefits like prescription drug coverage, vision, dental care and more.  

However, because Medicare Advantage plans are provided by private insurance companies, the payment structure is a bit different than Original Medicare.

Medicare Advantage plans will have a copay for every service, including doctors visits, specialist visits, and urgent care visits. The trade-off is that most Medicare Advantage plans have a low or even $0 premium.

This set up means that you would pay out-of-pocket for your healthcare — but only when you need it. Medicare Advantage plans can be great options for those who receive minimal healthcare so that you only pay for what you’ve used.  

Read more: Why Is There a Big Push to Buy Medicare Advantage?

Do Medicare Supplement plans have copays?

Most often, Medicare Supplements do not have copays.

The beauty of Medicare Supplement plans is the “set it and forget it” glory of paying your monthly premium and not having to worry about out-of-pocket expenses. You’ll likely have a small annual deductible, but the impact is usually minimal compared to traditional out-of-pocket costs.  

Medigap Plan F and G are the most popular plans we recommend that don’t have copayments attached. However, if you choose Plan N, you will have to pay a copay of up to $20 for doctor visits and $50 for ER visits.

A lack of copays is what makes Medigap so appealing to those who receive a lot of medical care. At a certain point, paying the monthly premium becomes more cost effective than shelling out a copay every time you seek care.

Medicare Supplement 2021 plan comparisons

  Medigap Plan F Medigap Plan G Medigap Plan N
Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up Yes Yes Yes
Part B coinsurance or copayment Yes Yes Yes, but you do have copays of up to $20 for office visits and $50 for ER visits
Blood (first 3 pints) Yes Yes Yes
Part A hospice care coinsurance or copayment Yes Yes Yes
Skilled nursing facility coinsurance Yes Yes Yes
Part A deductible Yes Yes Yes
Part B deductible Yes No No
Part B excess charges Yes Yes No
Foreign travel exchange (up to plan limits) 80% 80% 80%
Cost $$$ $$ $

Which Medicare Supplement plan should I get?  

Every Medigap plan is different, which is a huge win for accommodating all sorts of different needs. No human is quite the same, so why wouldn’t your health insurance adapt to you?

Fortunately, we recommend three great Medigap options:

  1. Plan F is the highest coverage option, but it often has the highest premium.*  
  2. Plan G is the mid-priced option that covers everything except your Part B deductible.  
  3. Plan N is for the frugal shoppers out there who want a lower premium in exchange for a few copays as they use the plan.

*You can only choose Medigap Plan F if you became eligible for Medicare before January 1, 2020.  

Read more: Is a Medical Savings Account (MSA) Better Than a Medigap Plan?

Conclusion  

Let us do the hard work and find the Medicare plan that is right for you.

If you are sick and tired of wondering about copay costs, Medigap may be right for you. Get a free quote today.

Luke Hockaday
By
Luke Hockaday
Luke Hockaday is a Customer Success Rep here at Medicare Allies. Luke has been helping Medicare-eligible clients with their insurance and retirement-planning needs since 2011. Luke is passionate about 3 things, and 3 things only: senior insurance, football, and food!

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