Medicare Supplement Plans in Illinois

Evaluating the various Medicare Supplement insurance plans in Illinois is a venture that can be well worth your time and effort. Information is available online to help in choosing from the many Medicare Supplement insurance plans in Illinois.

Recipients of original medicare Part A and Part B can get partial or full coverage of out-of-pocket expenses that are Medicare-approved by adding a Medicare Supplement. Out-of-pocket costs can be debilitating for some senior citizens.

The most common out-of-pocket expenses are:

• Medicare Part B Deductibles
• Coinsurance
• Copayment

Supplemental Medicare plans differ from original Medicare in that they are purchased through private insurance companies, while original Medicare is subsidized by the federal government.

Because these plans are designed to fill in the gaps left by Part A and Part B Medicare, they are referred to as Medigap plans. Illinois offers the same 10 Medigap plans that are available throughout the nation. These plans are named with a single letter and include A, B, C, D, F, G, K, L, M, and N.

Medigap plans are regulated by the Illinois Department of Insurance, which determines the specific plans available in the state. The most popular plans are Plans F, G, and N. Plan benefits must be the same throughout the state, but the costs to the recipient will vary. Consulting a Medicare insurance agent is helpful in making the right choice for you.

Medicare Supplement Plans in Illinois: Enrollment Statistics

Statistics from the Centers for Medicare and Medicaid Services (CMS) reveal that more than 1.6 million residents of the state were enrolled in Medicare (Original) in 2019.

Information obtained from America’s Health Insurance Plans (AHIP) showed that 767,081 residents of Illinois had a Medicare Supplement Policy in 2017. The most popular Medigap Plan was Plan F, with 509,279 Illinois residents enrolled in 2017.

The population of Illinois in 2018 was 12,741,080, with about 15.2 percent being over the age of 65. Medicare recipients are typically 65 or older, although Medicare is available to people with disabilities and those with End-Stage Renal Disease.

The number of Medicare beneficiaries statewide in 2016 totaled 2,108,645, making Illinois the 7th-ranked state in the United States for Medicare recipients.

The state also ranked 7th in the nation in total Medicare spending with a total of $22,250 million in 2016. The amount spent per beneficiary was $11,116, ranking 14th in the nation in this category.

Illinois’ five most densely populated counties also have the highest number of Original Medicare recipients. These are listed below, with population and number of enrollees in that order:

• Cook County – 5,250,510 / 590,171
• DuPage County – 934,100 / 118,056
• Lake County – 701,710 / 90,264
• Will County – 690,490 / 75,918
• Kane County – 531,900 / 56,474

Best Medicare Supplement Plans in Illinois

Ten Medigap Plans are available for state residents to choose from. Each of the health plans may be purchased from a wide variety of private insurance companies, with the price being set by the specific carrier.

Medicare Plan D in Illinois

Plan D Medicare provides drug coverage through an optional prescription drug plan that is often called a stand-alone policy, meaning it is not incorporated into a Medicare Advantage Plan or supplement plan.

These plans help pay the cost of FDA-approved, self-administered, Part B prescription medications. There may be premiums, deductibles, and co-payments for the recipient to cover.

Medicare Plan F in Illinois

The favorite Medigap plan in the state has been Plan F. This plan is considered to be first-dollar coverage because it includes everything, even the $198 Part B deductible. A bipartisan bill enacted by Congress on April 16, 2015 (the Medicare Access and CHIP Reauthorization Act or MACRA), included a plan to phase out the first-dollar health plans in order to cut down on Medicare spending. This change discontinues Medicare Part C and Medicare Part F for beneficiaries who become eligible on or after January 1, 2020.

One aim of discontinuing payment of the deductible was to assure that physicians are fairly paid for taking care of Medicare patients. Congress proposed that if recipients paid the deductible, Medicare could improve the payment doctors received and discourage them from discontinuing care for Medicare patients.

Medicare recipients who are already on a first-dollar supplement plan do not need to change their Medigap policy. Having been ‘grandfathered’ into the plan prior to 2020, no change would be necessitated by the 2015 legislation (MACRA).

The plan benefits include:

• Hospital coinsurance
• Costs of up to 365 days of hospitalization beyond the Original plan coverage
• Copays/Coinsurance for Hospice care
• Part A/B deductibles
• Part B coinsurance/copays
• Medicare Part B excess charges
• Coinsurance for skilled nursing facility care
• Limited emergency care with foreign travel

Medicare Plan G in Illinois

Plan G Medigap coverage has the one disadvantage of not paying for the monthly deductible expense, but it offers lower monthly premiums and $0 copays. All of the above-listed benefits are included in Plan G as well.

Medicare Plan N in Illinois

A third Medigap option in the state of Illinois is Plan N. The Part B deductible is not covered, nor are any excess charges. Part N requires a $20 copay for doctor’s office visits and a $50 copay for an Emergency Room visit. This is offset by the lower monthly premiums that are offered by top insurance companies like Blue Cross and Blue Shield.

When Can I Enroll in a Medigap Plan in Illinois

New Medicare recipients usually choose a supplement plan at the time of enrollment in Medicare Part B. An open enrollment period (OEP) begins on the first day of the month an enrollee turns 65 and lasts for six months.

During this period, you can choose any insurance company and Medigap Plan with guaranteed issue rights and no medical underwriting required. The insurance company cannot charge higher rates due to pre-existing conditions during this enrollment period.

Once the open enrollment period ends, insurance carriers can charge increased rates, require medical underwriting, or deny coverage to the applicant. After enrollment in a plan, you will have continuous coverage as long as the monthly premiums are paid and renewal is guaranteed regardless of health status.

Medicare Advantage Plans in Illinois

In addition to the above Medicare coverage options, many people with low or fixed incomes choose to enroll in Medicare Advantage Plans. A popular choice in Medicare Advantage is an HMO (Health Maintenance Organization) that focuses on Medicare preventive care. Other Medicare Advantage options are PPOs (Preferred Provider Organization) and POS (Point of Service) Plans.

Advantage Plans offer quality health care with good coverage for Medicare benefits like care in a skilled nursing facility and some home health services. There may be some out-of-pocket costs such as daily coinsurance and hospital deductibles. Many medicare advantage plans waive the 3-day initial qualifying stay in a skilled nursing facility before coverage kicks in.
Most Medicare Advantage Plans have prescription drug coverage and do not allow the addition of a Part D prescription drug plan.

Illinois Medicare Resources

When shopping for insurance, whether health or life insurance, consulting an insurance agent is a wise step. The agent can show you a comparison rate chart that lists all the information you need in an easy-to-follow format.

Additional Resource: https://www2.illinois.gov/cms/personnel/benefits/Pages/WhatisMedicare.aspx