The Best Medicare Supplement (Medigap) Plans in Illinois
- Illinois Medigap policies help Medicare beneficiaries cover copays, deductibles and other related costs. Let our review of available Medigap plans in Illinois help you select a suitable plan.
If you’re enrolled in Medicare Parts A and B, Medicare supplement insurance (Medigap) can help you pay any out-of-pocket costs that remain after reimbursement. Nearly 800,000 Illinois citizens currently take advantage of Medigap, which may cover expenses such as deductibles and copays. That’s about 45% of Medicare beneficiaries.
Because Medigap plans are available in a wide range of price points and coverage options, Medicare beneficiaries who are considering a plan should be able to find one that fits comfortably into their budget. The information included in this article is designed to help you understand the Medigap coverage options available in Illinois.
You can find Medicare Supplement plans where you live by comparing plans from several different insurance companies online.
What Are the Best Illinois Medicare Supplement Plans?
Although Medigap is sold by private insurance companies, all plans fall into one of 10 categories, which are identified using a single letter between A and N. Plans across all 10 categories offer the same base of benefits, which includes reimbursement for all or a portion of the expenses related to:
- Part A and B coinsurance
- Part A hospice care copays or coinsurance
- Blood transfusions
- 365 days of inpatient hospital care after Original Medicare benefits are exhausted
Benefits are standardized by plan category, which essentially means that any plan with the same letter designation — e.g. Plan N — offers the same benefits regardless of what company issues the policy. Some plan types also offer coverage for services such as residential skilled nursing care and foreign travel exchange or charges for services and supplies that exceed the amount approved by Original Medicare.
Plans may pay between 50% and 100% of the balance remaining after Medicare reimbursement for covered services, and limitations or restrictions may apply. Coverage terms vary by plan type. The included chart provides a more comprehensive comparison of the coverage terms for each Medigap plan.
Although your choice of Medigap plans should reflect your unique needs, many beneficiaries opt for Plans F, G or N. These popular options typically have lower premiums, making them more affordable for many seniors, and all three of these plans cover residential skilled nursing care coinsurance and 80% of foreign travel exchange. However, only beneficiaries who initially became Medicare-eligible before January 1, 2020, may enroll in Plan F. These popular Medigap plans may also come with a high deductible, which must be met before you’ll receive reimbursement.
Each Medigap issuer in Illinois is allowed to offer a different selection of plans, but they all must offer Plans A, C and F. Because these letter-designated plans are standardized by type, the major difference between insurers is the cost of the premium, so it’s worth shopping around.
How Do I Enroll in an Illinois Medigap Plan?
You’re eligible to purchase Medicare supplement insurance once you turn 65 and enroll in Medicare Part B. If you want to purchase a plan, the optimal time to enroll is during Medigap’s open enrollment period. This enrollment period begins on the first day of your 65th birthday month and remains open for six months. During this time, you’ll be able to enroll in any plan, and insurers may not deny you coverage or charge higher premiums based on medical conditions or other health risks.
If you’re 65, but receive health care benefits through an employer or union, you may not want to enroll in Medicare Part B when you’re initially eligible. In this case, your six-month Medigap enrollment period begins when your employer- or union-sponsored coverage ends and you enroll in Original Medicare.
After your Medigap open enrollment period ends, you’re no longer guaranteed to get a policy. Once this initial enrollment period ends, insurers are legally allowed to use a medical underwriting process to assess applicants, and they may deny you coverage or charge higher premiums if you’re considered a high risk.
However, if you meet certain requirements, federal law still guarantees your right to enroll in a policy. These are known as guaranteed issue rights, and if you have a guaranteed issue right, Medigap providers must sell you a policy regardless of medical underwriting outcomes.
A Medicare beneficiary may have a guaranteed issue right if they lost their current Medigap coverage through no fault of their own and need to purchase a new plan or if they reverted from Medicare Advantage to Original Medicare for one of the following reasons:
- There was a discontinuation of the enrollee’s Medicare Advantage plan.
- The enrollee moved out of their Medicare Advantage plan’s service area.
- The enrollee's Medicare Advantage plan no longer covers the area they reside in.
- The enrollee tried out a Medicare Advantage plan but decided to switch back within the year.
Guaranteed issue rights may also apply if you’ve lost an employer-sponsored health care plan that supplemented your Medicare coverage or if you relinquished your current Medigap coverage as a result of an insurance company’s misleading policies or refusal to follow federal guidelines.
If you fall into one of these categories, you may purchase a Medigap plan after the formal enrollment period is over, and an insurer can’t refuse you coverage or charge you a higher premium due to health risks. Guaranteed rights protections typically last for 63 days after other relevant coverage ends, but in certain circumstances, beneficiaries may have an additional year to apply for a Medigap plan.
Medigap plans aren't available to Medicare Advantage enrollees and individuals under the age of 65, even if they're enrolled in Original Medicare.