Understanding Medicare Supplement (Medigap) Plans in Illinois

While Original Medicare (Part A and Part B) provides a strong foundation for your healthcare, it doesn’t cover everything. Out-of-pocket expenses, such as deductibles, copayments, and coinsurance, can add up, resulting in some outrageous medical bills. For many people in Central Illinois, this is a significant concern. This is where a Medicare Supplement plan, also known as Medigap, can provide crucial financial protection and peace of mind.


As a key part of our overall Medicare Solutions, this page will explain what Medigap plans are, the benefits they offer, and how they work. At StAK Insurance Solutions, our goal is to help you understand if a Medigap policy is the right choice to secure your health and financial future.


What Are the Benefits of a Medigap Plan?

Medigap plans are sold by private insurance companies and are explicitly designed to "fill the gaps" left by Original Medicare. For those who value stability and freedom in their healthcare choices, the advantages of Medigap may be to your liking.

Predictable Healthcare Costs

One of the biggest benefits of a Medigap plan is cost predictability. By covering many of your out-of-pocket expenses, these plans make it much easier to budget for your healthcare. Depending on the plan you choose, you could have little to no costs when you visit a doctor or hospital, beyond your monthly premiums.

Freedom to Choose Your Doctors

Medigap plans do not use provider networks. This means you have the freedom to see any doctor or visit any hospital in the United States, as long as they accept Medicare patients. This is a major advantage for people who travel or want to ensure they can continue seeing their preferred specialists without worrying about network restrictions.

Guaranteed Coverage During Open Enrollment

When you first become eligible for Medicare, you have a 6-month Medigap Open Enrollment Period. During this time, an insurance company cannot use your health history to deny you a policy or charge you more. This is the best time to purchase a plan, as it guarantees your acceptance.

Standardized, Easy-to-Compare Plans

While Medigap plans are sold by different private companies, the benefits for each lettered plan are standardized by the federal government. This means that a Plan G from one company has the exact same basic benefits as a Plan G from another company, making it easier to compare plans based on price and company reputation.

 A Detailed Look at Medigap Coverage

While the big-picture benefits are about financial peace of mind, it's helpful to see exactly what costs Medigap plans can cover. Depending on the specific lettered plan you choose, a Medigap policy can help pay for:

Part A Coinsurance and Hospital Costs:

Covers the daily hospital costs you would otherwise pay after you've been in the hospital for an extended period.

Part B Coinsurance or Copayment:

Covers the 20% of the Medicare-approved amount for most doctor visits and outpatient services that you would normally be responsible for.

Blood (First 3 Pints)
Helps pay for the first three pints of blood needed for a medical procedure each year.

Part A Hospice Care Coinsurance or Copayment

Covers the out-of-pocket costs associated with hospice care.

Skilled Nursing Facility Care Coinsurance
Helps pay the daily coinsurance for care in a skilled nursing facility.

Part A Deductible
Covers the significant deductible you must pay for each hospital benefit period.

Part B Excess Charges
Helps pay for the first three pints of blood needed for a medical procedure each year.

Foreign Travel Emergency

Provides coverage for emergency medical care when you are traveling outside the United States (up to plan limits).

How We Help You Choose the Right Medigap Plan

Navigating the different Medigap options can seem confusing, but our process for how to choose a Medigap plan is designed to bring you clarity and confidence.

Step 1: Confirming Medigap is the Right Path for You

First, we sit down with you to discuss your healthcare needs, budget, and priorities. We'll help you weigh the pros and cons in the Medigap vs Medicare Advantage decision, ensuring you choose the path that aligns with your long-term goals.

Step 2: Comparing the Different Lettered Plans

In Illinois, you can choose from several standardized Medigap plans. While there are many options, most new enrollees choose between Plan G and Plan N, as they offer excellent coverage.

Medicare Supplement Plan G:

This is the most comprehensive option available to new Medicare beneficiaries. It covers nearly all of your out-of-pocket costs, including your Part A hospital deductible and your Part B coinsurance. The only thing it doesn't cover is your annual Part B deductible. Once you've paid that, you can expect 100% coverage for Medicare-approved services.

Medicare Supplement Plan N:

This plan is another popular choice that offers great coverage but with a slightly lower monthly premium than Plan G. In exchange, you agree to pay a small copay (up to $20) for some doctor's office visits and a $50 copay for emergency room visits that don't result in a hospital admission.

We will explain these differences in detail and help you find the plan that offers the right balance of cost and coverage for you.

Step 3: Finding the Right Insurance Company

Because the benefits of each lettered plan are the same, the main differences between policies are the price and the reputation of the insurance company offering it. As independent agents, we work with multiple highly-rated carriers. We can provide you with quotes from these different companies, helping you find the most competitive price for the plan you choose.

Frequently Asked Questions About Medigap

  • What is the difference between Medigap and Medicare Advantage?

    Original Medicare includes Part A (hospital insurance) and Part B (medical insurance) and is provided by the federal government. Medicare Advantage (Part C) plans are offered by private insurance companies and bundle hospital, medical, and often prescription drug coverage into one plan. Medicare Advantage plans may also offer additional benefits like dental, vision, and hearing coverage. The best choice depends on your budget, preferred doctors, and healthcare needs.

  • Can I be denied a Medigap policy because of my health?

    This is a top priority for most people. If you choose a Medigap plan to go with Original Medicare, you can see any doctor in the U.S. who accepts Medicare. If you are considering a Medicare Advantage plan, we will look up your specific doctors and specialists to ensure they are in the plan's network before you enroll.

  • Do Medigap plans cover prescription drugs?

    No, Medigap plans sold today do not include prescription drug coverage. To get help with your medication costs, you will need to enroll in a separate Medicare Part D Prescription Drug Plan. We can help you find a Part D plan that covers your specific medications.

Explore Your Other Medicare Options

Understanding all your options is key to making the best decision. Learn more about the other parts of Medicare.

Medicare

Advantage Plans

An all-in-one alternative to Original Medicare.

Prescription

Drug Plans (Part D)

Essential coverage for your medication needs.

Return to our main Medicare Solutions page for a complete overview.

Let's Find Your Medigap Plan Together

Ready to find the peace of mind that comes with predictable healthcare costs?

 Let's have a simple, no-pressure conversation about your Medigap options.

Let our family help yours find the right coverage.