WHAT YOU MAY NOT KNOW ABOUT YOUR MEDICARE SUPPLEMENT PLAN

Michael T. Braden, November 7, 2025 MEDICARE SUPPLEMENTS

Photo of Prescription Tablets and $100 Bills with the caption "What are the benefits of Medigap insurance?"

When those new to Medicare first enroll in Medicare, they are mainly focused on the cost of their premiums, what their deductibles are, whether or not all of their favorite doctors and hospitals are in their network, and how in the world they are ever going to remember everything about Medicare!

Medicare Supplement plans, also known as Medigap, are designed to fill the gaps left by Original Medicare. Still, for many people, the benefits of having a Medigap/Medicare Supplement Policy are sadly never made clear to them, especially if they self-enrolled or worked with a Medicare Agent/Broker who wasn't as thorough or detailed as they should have been.

Many of the most important aspects of Medicare Supplement/Medigap plans are oftentimes hidden in the plan's fine print. These benefits do not just save you money; they can save you thousands during a serious medical event. Understanding these overlooked features helps you appreciate the true value of your policy and why a Medigap plan offers confidence and peace of mind, knowing you are well covered beyond basic healthcare.

NO CO-PAYS OR CO-INSURANCE

One of the most immediate benefits of a MEDIGAP or MEDICARE SUPPLEMENT Plan/Policy is the full coverage of your Medicare Part B charges.

Under Original Medicare, you are responsible for 20% of the Medicare-approved amount for most doctor services, outpatient therapy, and durable medical equipment. There is no cap on this 20%, meaning if you have a $100,000 surgery, you could owe $20,000.

Most Medigap plans cover this entire 20% cost for you. This means that after you meet your annual Part B deductible ($283 for 2026), you can relax and rest assured that you will not be on the hook for unexpected Medical procedures or emergency health issues.

ENHANCE PART A BENEFITS THAT EXCEED ORIGINAL MEDICARE

Hospital stays can be costly, and Original Medicare has limits. Part A covers your hospital costs for the first 60 days of a benefit period after you pay a deductible. However, if your stay extends beyond that, you begin to pay a daily coinsurance amount that increases significantly over time.

Medicare Supplement plans provide a crucial safety net here. They cover the Part A coinsurance for days 61-90 and your Lifetime Reserve Days for days 91-150. Even more importantly, once you have exhausted all your Medicare hospital benefits, Medigap plans provide coverage for an additional 365 days of inpatient hospital care during your lifetime. This extended coverage is a benefit we hope you never need, but it is invaluable if you do.

Photograph of Braden Medicare Insurance's 2026 Medicare Supplement Plan Comparison Chart

GREATER BENEFITS FOR SKILLED NURSING FACILITIES

Recovering from a serious illness or injury often requires time in a Skilled Nursing Facility (SNF). Medicare Part A covers the first 20 days in full, but from day 21 through day 100, there is a daily coinsurance charge. For 2026, this daily cost is $217.

That daily fee adds up quickly—over $6,500 for a month-long stay. Medigap plans protect your savings by covering the coinsurance amount in full. This allows you to focus on your rehabilitation and recovery rather than worrying about a mounting daily bill.

COVERING PART B EXCESS CHARGES

Some doctors and providers do not accept Medicare Assignment, meaning they do not agree to accept the Medicare-approved amount as full payment. By law, these providers can charge you up to 15% more than the Medicare-approved rate. These are called “excess charges.”

If you have a Medicare Supplement Plan F or Plan G, the plan pays 100% of these excess charges for you. You can see any doctor who accepts Medicare, even if they do not accept assignment, and you will not see a bill for that extra 15%. This benefit significantly widens your access to specialists and top-tier medical centers.

COVERAGE FOR BLOOD TRANSFUSIONS

Original Medicare only pays for blood transfusions starting with the fourth pint of blood in a calendar year. You are financially responsible for the first three pints, which can be surprisingly expensive. Now, raise your hand if you knew that the cost for a Pint of Blood averages $200 - $300! I think most people are shocked the first time they see charges for Blood after Surgery or after a Hospital Stay.

Thankfully, every Medicare Supplement/Medigap plan covers the first three pints of blood, making sure that you, the Medicare Beneficiary, are not stuck with a hefty bill.

20% CO-PAYS FOR MEDICAL EQUIPMENT (DME)

Durable Medical Equipment (DME) includes items like wheelchairs, walkers, CPAP machines, and hospital beds. Under Original Medicare Part B, you typically pay 20% of the cost for this equipment.

Because DME can be costly, that 20% share can be a burden. Your Medicare Supplement plan steps in to pay this coinsurance, making essential equipment affordable and accessible when you need it most to maintain your independence at home.

CONSISTENT COSTS FOR YOUR BUDGET

Perhaps the most “overlooked” benefit is not a specific medical service, but a financial one: predictability. With a Medigap plan, you know exactly what your costs will be. You pay your monthly premium, and in return, you have little to no out-of-pocket expenses for covered services.

This predictability makes retirement budgeting much easier. You do not have to set aside a large “rainy day” fund for medical copays or surprise bills because your insurance is doing the heavy lifting for you.

OVERSEAS EMERGENCY BENEFITS

Medical emergencies often happen when we are least prepared. Whether it is a sudden need for emergency care while traveling abroad – which many Medigap plans cover up to a lifetime limit of $50,000 – or protection against unexpected “excess charges” from a specialist, these plans are designed to handle the surprises.

By filling the financial gaps left by Original Medicare, a Supplement plan serves as a shield against catastrophic costs that could otherwise derail your retirement finances.

COMPANIES MAY OFFER ADDITIONAL BENEFITS

While the government standardizes the medical benefits of Medigap plans, private insurance carriers often compete for your business by offering extra perks. These can include “household discounts” if you and a spouse both enroll, or memberships to gym networks like SilverSneakers, Renew Active, and Silver & Fit, or Active & Fit.

Some carriers also offer add-on packages for vision, dental, and hearing coverage, which are not covered by Original Medicare or standard Medigap plans. It is always worth asking what “extras” are available when you compare quotes.