Private health insurance companies provide Medicare Supplement Plans. Which cover at least some or all of your Part A deductible and Part B coinsurance, filling the gaps in Original Medicare (Parts A and B). Despite the fact that private companies sell these plans, the government regulates them. The government also ensures that all Medicare Supplement Plans with the same letter name offer the same benefits throughout the country.
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Since private insurance companies set premium prices, premiums will vary depending on the insurance company you select. So, it’s critical to compare Medicare Supplement Plans and insurance companies to find the best plan for you. You can compare all of your options using EZ. But first read our full explanation of Medicare Supplement Plans in Vermont.
Vermont Medicare Supplement Plans
Look into a Medicare Supplement Plan if you need help paying for your Medicare Part B coinsurance, or if Original Medicare doesn’t cover everything you need.
If you live in Vermont and require a Medicare Supplement Plan, you should be aware that there are ten different plans. Each beginning with a different letter of the alphabet. All insurance companies must offer Plan A. However, Plans C and F are only available to people who qualified for Medicare before January 1, 2020.
A Medicare Supplement Plan has a monthly premium. But for this one affordable payment, your plan will cover the majority (or almost all) of your out-of-pocket expenses. Monthly premiums in Vermont range from $77 to $381, depending on the plan and where you live.
Plan A
Plan A is the most basic Medicare Supplement Plan available. Despite its simplicity, it will cover what many people believe is the most important thing that Medicare Supplement Plans can cover: the 20% of outpatient services that Part B does not cover. It also covers a select few other major expenses, as outlined below.
All Medicare-approved health insurers legally have to provide Plan A. But in some areas, Medicare-eligible people under the age of 65 are not guaranteed access to Plan A.
In Vermont, Plan A generally costs between $107 and $218 per month.
Plan B
Medicare Supplement Plan B covers all the basics that Plan A does, including:
- Medicare Part A coinsurance and hospital costs – Part A only fully covers your first 60 days of inpatient hospital stays in a benefit period, after that you are required to pay a portion of your bills for each day after your initial 60 days. Days 61-90 have a coinsurance of $400 a day. If your stay is between 91 and 150 days, and you use your Lifetime Reserve days, your coinsurance will be $800 a day. Plan B covers 100% of these costs.
- Medicare Part B coinsurance or copay – You’ll typically have to pay Medicare Part B coinsurance for doctor visits and other outpatient care. So, Medicare Part B pays 80% of the Medicare-approved amount for covered services, leaving you to pay the remaining 20%. Plan B covers 100% of this.
- First 3 pints of blood – Original Medicare only pays for the fourth and subsequent pints of blood if you need blood during treatment. Plan B will pay for the first three pints.
- Part A hospice care and coinsurance – Hospice care is for patients who are nearing the end of their lives. These services are covered by Medicare, but copayments are required. These copayments include $5 for each symptom and pain relief medication prescription, as well as 5% of the Medicare-approved amount for inpatient assisted living. Plan B covers all expenses related to hospice care.
Plan B differs from Plan A in that it covers the Medicare Part A hospital deductible, which Plan A does not. The Part A deductible is $1,600 in 2023, and because this deductible is charged on a 60-day basis rather than annually (meaning you might have to pay it more than once in a year), having a plan that covers it could be very beneficial.
Medicare Supplement Plan B costs between $172 and $327 per month for Vermont residents.
Plan C
Plan C is one of the best Medicare Supplement Plans in terms of coverage, but not everyone who has Medicare has access to it. Medicare Supplement Plan C covers everything except for Part B excess charges. This means that it pays for your Parts A and B deductibles, as well as your 20% coinsurance for all outpatient care.
Coverage includes the following:
- Part A hospital deductible and coinsurance
- Hospital costs up to an additional 365 days after Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Blood (the first 3 pints)
- Other Medicare-approved expenses associated with Part A hospitalization
- Medicare Part B coinsurance and copayments
- Part B deductible
- Other Medicare-approved expenses associated with Part B coverage
People who became Medicare-eligible after January 1, 2020, no longer have the option to select Plan C. You can keep Plan C if you had it before January 1, 2020, and you might be able to buy it now if you became eligible for Medicare before 2020 but did not enroll then.
Monthly premiums for Plan C can cost anywhere from $183 to $381 in the state of Vermont.
Plan D
Plan D covers the majority of out-of-pocket expenses associated with Original Medicare, including:
- Part A hospital coinsurance and hospital costs up to an extra 365 days after Original Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Part B coinsurance
- First 3 pints of blood
- Skilled nursing facility (SNF) care coinsurance – After the 20th day of your stay as an inpatient in a skilled nursing facility, Medicare Part A requires you to pay coinsurance. Part A coinsurance for skilled nursing facility care is $200 per day in 2023.
- Part A deductible
- 80% of foreign travel emergency costs (up to plan limits)
This means that Plan D covers almost everything, except Part B deductibles and Part B excess charges. If your doctor doesn’t accept Medicare assignment, they can charge you more than Medicare will pay for the service. The difference between these amounts is called an “excess charge”; you will have to pay this difference with Plan D.
In Vermont, monthly premiums for Plan D can cost between $160 and $363.
Plan F
Plan F is the most popular Medicare Supplement Plan and has been for a long time. But like Plan C, it is no longer available to all beneficiaries. It is so popular because it is extremely comprehensive: if you have this plan, you only need to worry about the monthly Plan F premium. This plan covers:
- Part A hospital deductible and coinsurance
- Hospital costs up to an additional 365 days after Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Blood (the first 3 pints)
- Other Medicare-approved expenses associated with Part A hospitalization
- Medicare Part B 20% coinsurance and copayments
- Medicare-approved doctor’s office fees
- Part B deductible
- Medicare Part B excess charges
- Other Medicare-approved expenses associated with Part B coverage
The only caveat is that individuals who are or will be qualified for Medicare after January 1, 2020 are not permitted to enroll in Plan F. You are eligible to enroll in one of these plans if you became eligible for Medicare before the year 2020. If you are “grandfathered in,” you can keep Plan F for as long as you like.
Monthly premiums for Plan F can range anywhere from $165 to $378, depending on your location.
Plan G
Plan G is worth considering if you’re interested in something like Plan F but don’t meet the requirements to buy it. You’ll get nearly all the benefits of Plan F with Plan G, including coverage for:
- Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
- Part A deductible
- Part A hospice care coinsurance or copayment
- Part B coinsurance or copayment
- Part B excess charges (if a provider is permitted to charge more than Medicare’s approved amount and does so)
- Blood transfusion (first 3 pints)
So, Plan G covers everything except for the Part B deductible, and is typically more affordable than Plan F. Medicare Supplement Plan G premiums often cost less than Plan F premiums do, ranging in Vermont from $145 to $343 per month.
Plan K
Plan K helps pay for some of the costs not covered by Original Medicare, but at a lower rate than other plans. Until you hit your annual out-of-pocket maximum, Plan K only covers 50% of some costs. Coverage includes:
- Medicare Part B coinsurance – Plan K covers half of these costs, so you will be responsible for 50% of your 20% Part B coinsurance. For example, if your doctor charges $100 for a service, Medicare will cover $80, Plan K will cover $10, and you will cover the remaining $10.
- First 3 pints of blood
- Part A hospice care coinsurance or copayment – Plan K will pay for half of these costs.
- Skilled nursing facility care coinsurance – Plan K pays half of the coinsurance for medical care in skilled nursing care facilities.
- Medicare Part A deductible – Medicare Supplement Plan K will pay half of these deductibles, or $800.
When compared to other plans, Plan K is more expensive. But unlike other plans, Plan K places a cap on you out-of-pocket expenses. This cap is your annual out-of-pocket maximum. So, if you go with Plan K, the most you’ll have to pay annually is $6,620 (as of 2023). After you reach this spending threshold, Medicare Supplement Plan K will begin to pay for the rest of your permitted costs for the remainder of the year. Your limit will reset at the beginning of each new calendar year.
In addition to this, Plan K will pay 100% of your Medicare Part A coinsurance, which you would otherwise have to pay for hospital stays that are longer than sixty days. This is the only basic benefit that Plan K covers in full.
Plan K has lower monthly premiums that can cost anywhere from $77 to $151 in Vermont.
Plan L
Like Plan K, Plan L pays for some of the costs that are not covered by Original Medicare, but Plan L covers these costs at a higher percentage than Plan K does. In addition, it has a lower annual out-of-pocket maximum than Plan K’s ($3,310 in 2023), after which your insurance company will begin covering everything in full.
Medicare Supplement Plan L pays 100% of the hospitalization and coinsurance costs associated with Medicare Part A. In addition to that, it pays for a portion of the following:
- Medicare Part B coinsurance – Plan L covers 75% of your Part B coinsurance.
- Blood – If you require blood while in the hospital, Plan L will cover 75% of the cost of the first three pints.
- Part A hospice care copayments – Plan L pays 75% of your Part A copays for hospice care.
- Skilled nursing facility care coinsurance – Plan L pays 75% of the $200 per day (after the 20th day of your stay) coinsurance for medical care in skilled nursing care facilities.
- Part A deductible – Medicare Supplement Plan L will cover 75% of your Part A deductibles for each 60-day benefit period . You must still meet your Medicare Part B deductible, which is $226 per year in 2023, if you choose Plan L.
Plan L premiums cost between $133 and $174 a month in Vermont.
Plan M
Medicare Supplement Plan M helps with some but not all of the costs that come with having Original Medicare coverage. But it covers more expenses in full than either Plan K or Plan L does
Medicare Supplement Plan M covers Medicare Part A hospital costs in full. Additionally, it covers:
- Medicare Part B coinsurance – Plan M pays your Part B coinsurance and/or copayments in full.
- Blood – If you require blood while in the hospital, Medicare Supplement Plan M will cover the first three pints of blood in full.
- Part A hospice care coinsurance or copayment – Plan M will cover all of your hospice care coinsurance and copays in full.
- Skilled nursing facility care coinsurance – Plan M covers the entire cost of Part A skilled nursing facility coinsurance.
- Part A deductible – Medicare Supplement Plan M will cover half of your Medicare Part A deductible. If you have Plan M, you will have to pay half of the $1,600 (or $800) deductible rather than the full $1,600.
Prices for Plan M premiums range from $204 to $303 a month in Vermont.
Plan N
Most of Original Medicare’s coverage gaps are filled by Medicare Supplement Plan N. Only the Part B deductible and any Medicare Part B excess charges, which are parts of doctor bills that are more than the Medicare-approved amount, are not covered. But, unlike some other plans, you may have copayments for some Part B services.
This means Medicare Supplement Plan N covers all of the following:
- Medicare Part B coinsurance – Plan N will cover your Part B coinsurance costs in full, with the exception of a copayment of up to $20 for some office visits. For emergency room visits that do not result in an inpatient admission, a second copayment of up to $50 may be required.
- Blood – If you require blood while in the hospital, Medicare Supplement Plan N will cover the first three pints.
- Part A hospice care coinsurance or copayment – Plan N pays your hospice care coinsurance and copayments in full.
- Skilled nursing facility care coinsurance – Your skilled nursing facility coinsurance will be fully covered by Medicare Supplement Plan N.
- Part A deductible – Medicare Supplement Plan N pays your $1,600 deductible in full for each 60-day benefit period.
- Foreign travel emergency care – Original Medicare typically does not cover medical care received outside of the United States. If you need emergency care while traveling outside of the United States, Medicare Supplement Plan N will cover 80% of the costs of qualified emergency medical care.
Prices for Plan N can range from $119 to $209 a month in Vermont.
When To Enroll
There is no set annual enrollment period for Medicare Supplement Plans. Instead, you will be given the opportunity to enroll with guaranteed-issue rights if you sign up during your Medicare Supplement Open Enrollment Period. This period is the six months beginning when you turn 65 and enroll in Medicare Part B. It’s important to enroll during this period because it is the only time you will be given these guaranteed-issue rights. Which means insurance companies will not be able to deny you or charge you more because of your health.
If you are under 65 but qualify for Medicare due to a disability, though, access to a Medicare Supplement Plan is not guaranteed by federal regulations. To address this issue, the vast majority of states, including Vermont, have enacted regulations that guarantee people under 65 at least some access to Medicare Supplement Plans. During the initial six months following your enrollment in Medicare Part B, the state of Vermont requires Medicare Supplement insurers to make all of their plans accessible to you, regardless of your age.
How To Choose
When it comes to Medicare coverage, don’t be afraid to ask questions. Speak to an EZ agent who can explain everything to you and give you guidance on how to sign up. EZ can assist you in enrolling in Medicare, comparing Medicare Supplement Plans, or simply weighing your options. Our agents work with the best insurance companies in the country. So, they can provide you with a free comparison of all available plans in your area. We will go over your medical and financial needs and help you find a plan that works for you. To get started, simply enter your zip code in the bar below or give one of our licensed agents a call at 877-670-3602.
