“Medigap” is a type of Medicare supplement insurance coverage intended to fill in the coverage gaps associated with Original Medicare Parts A & B. While Medicare attempts to be comprehensive, there are many healthcare basics that it doesn’t cover. And if you don’t have any Medigap insurance to cover those necessities, you could wind up spending thousands in out-of-pocket healthcare bills. In order to acquire Medigap insurance, you have to first be enrolled in Original Medicare.

Federal Regulations for Medicare Supplements

The CMS (Centers for Medicare and Medicaid Services) is the government body accountable for controlling the 10 Medigap plans that are available for purchase. Because plans are regulated, you can rest assured that Plan C or G policy coverage in Illinois is the same as it would be in any alternative state. What you need to be concerned about is selecting the best company, and acquiring an inexpensive premium.

Medigap Enrollment In Illinois

There are well over half a million senior citizens in Illinois who prefer to cover their Medicare coverage gaps with a Medigap policy. In the chart below, you will see that Plan F, as in many other states, is the most popular plan. Plan D is still fairly popular as well.

Plan Type A B C D E F G H I J K L M N
Enrollment 5,170 6,262 28,644 36,768 3,045 453,875 29,335 309 1,878 16,839 1,349 2,909 19 18,943

Plan Coverage & Cost

A number of elements will determine how much your insurer could charge you for your Medicare supplement plan. As an example, a 75 year-old, female non-smoker in New York will pay a substantially different premium from a 66 year old man in Illinois who chewed tobacco for 20 years.

The good news is you can’t be turned down for Medigap plans. There are no prequalifying issues. If you qualify for Medicare, you qualify for Medigap coverage. The premium for that coverage depends on a number of factors. Your current overall health will be considered along with your medical history. Your age and gender will also be considered. Surprisingly, so will where you live in Illinois, right down to your zip code. Healthcare costs in Chicago are greater than they are in Peoria, consequently, local costs are calculated into the premium.

Most Popular Medicare Supplement Plans in Illinois

Just like several states, Illinois inhabitants have a preference for Medigap Plan F over the majority of Medicare supplemental insurance plans. It’s reasonably easy to see the reason why: Plan F covers 100% of the coverage gaps which can be found in Traditional Medicare and offers more benefits than the alternative 9 plans. However, because Plan F is so comprehensive, it is also the most expensive Medigap plan on the market.

Illinois does differ in that Plan D is relatively popular among seniors who do not sign up for Plan F. If you do not anticipate expensive rates from your Medicare Part B, especially with regard to your Part B Deductible and potential Part B excess charges, then Plan D might be a more affordable option than Plan F.

How do Medicare Plan Ratings Work?

Medicare provides a helpful tool called Overall Star Rating that assists consumers in evaluating the different private insurance companies providing supplemental coverage for Medicare. Basically, Medicare collects data on every company and uses that information to rate each company in five different categories. Those categories are how well preventive measures like screenings, tests and inoculations are used, how effective chronic disease is managed, how satisfied members of the plan are, complaints, and customer service. You can use these star ratings to compare companies you are considering.

Helpful Medigap Tips & Tricks

Doctor/Provider Network Restrictions

One of the main reasons Medigap coverage is well liked among seniors is due to the flexibility of such plans. Compared with other supplement programs, Medigap insurance doesn’t include any restricted PPO or HMO provider networks. You can utilize any doctor which will accept Medicare, in any state, wherever you are. If you want to travel, if you are living in a non-urban area, or in case you are one of millions of “snow birds” who travel south every winter, your access to suitable medical care isn’t going to be limited.

Doctors List

Freedom of choice is a major advantage of Medigap plans over other Medicare plans. If you like your doctor, you can keep your doctor as long as they accept Medicare. If you see a specialist, you’ll be able to continue seeing that specialist. All that’s required is your healthcare providers have to accept Medicare assignment. That means your doctor or facility agrees to Medicare payment rates, will file a medical claim on your behalf, and agrees not to charge you more than the copay required by your plan. Other plans typically work with networks and your choice of providers is limited to members of a specific network.

Drug, Vision and Dental Coverage

In the year 2010, the US government passed legislation which changed how Medicare supplement insurance dealt with prescription drug coverage. Since Medicare Part D is out there, All Medigap plans which provided prescription drug coverage are being eliminated. Vision and dental benefits are a different matter entirely. They have never been included in either Medicare or Medigap, and should be purchased on their own from a private company in case you have a need for those services.

Enrollment Options & Best Time To Enroll

When you register for a Medigap policy, you will need to first be signed up for Medicare Parts A & B. Then you can start the Medigap enrollment process. The quicker you register, the less difficult the process will be. But in case you delay, you may have to answer personal questions regarding your health to be considered qualified to receive coverage.

  • Initial Enrollment Period: You will be guaranteed coverage, with no hassle, if you obtain a Medicare supplement plan within your first 6 months of registering for Medicare.
  • Guaranteed Issue: You won’t be turned down for coverage, despite a health issue. This is a popular option among golden-agers transferring from an employer or group plan.
  • Annual Enrollment Period (AEP): Contrary to many types of insurance, you can enroll in a Medicare supplement policy whenever you want. You’re not restricted by an annual enrollment period.
  • Underwritten: In the event you miss the IEP and don’t meet the requirements for Guarantee Issue, you might have to go through the underwriting process. This typically involves queries about your overall health, and even a medical exam in order to evaluate whether or not your insurance company can cover you.

Free Look Period

If you enroll in a Medigap plan but eventually realize that it isn’t the right fit, there’s no need to worry – as long as you make that discovery inside the first 30 days of coverage. The “Free Look Period” gives senior citizens the authority to terminate their coverage for a full refund within the first 30 days if they aren’t totally satisfied with their plan.

What Medigap Plan Is Best For Me?

There’s no way to easily answer this question. Only you know what best fits your situation. It’s going to take a fair amount of research to find the perfect mix of coverage and cost. That starts with knowing who is out there in the marketplace. To help you with identifying candidates, Medigap.com has compiled a comprehensive list of companies in Illinois that offer Medicare Supplement plans.

We’ve also offer other information and don’t forget, the best plan is not always the least expensive plan. Know the coverage, find out how financially stable the company is and its reputation in order to make an informed decision.

by Lindsay Malzone, Lindsay Malzone is the Medicare expert for Medigap.com. She's been contributing to many well-known publications as an industry expert since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.