Medicare Supplement Plans in Illinois
Private insurance companies offer Medicare Supplement Insurance plans in Illinois. Also known as Medigap, these plans help cover a variety of healthcare costs if you have Original Medicare. This page explains how Medigap works, the best time to join a plan, and how to compare your options.
What Is Medigap in Illinois?
Medigap plans help pay for services that are covered by Original Medicare. This includes Part A, hospital insurance, and Part B, medical insurance. It does not include prescription drug coverage, eye exams, dental care, or hearing aids.
There is no limit to your out-of-pocket costs with Original Medicare. Without a Supplement plan, you may owe significant medical bills, particularly if you have any chronic conditions or require a lengthy hospital stay.
Illinois Supplement plans are standardized, meaning you get the same benefits no matter which Medigap insurer you choose. There are 10 basic plans, each represented by a letter (A, B, C, D, F, G, K, L, M, and N). Not every insurance company offers every plan. In addition, some insurers offer high-deductible versions of one or more Medigap plans.
Unless you have a guaranteed issue right, Medigap applications go through medical underwriting. This process involves answering a series of questions regarding age, tobacco use, medical history, and more. The insurance company uses your answers to decide whether to offer you a Medigap policy and at what rate.
Who Qualifies for Medicare Supplement Insurance in Illinois?
As long as you have Original Medicare, you qualify for Medicare Supplement Insurance in Illinois. The majority of Illinois Medicare beneficiaries – over 85 percent – are age 65 or older. The remaining 14 percent qualify for Medicare due to a disability.
Although Medigap insurers must offer plans to under-65 Medicare enrollees, they may charge a higher premium. However, Illinois law prohibits charging an under-65 Medigap applicant more than their highest rate for an over-65 beneficiary.
What Does Medigap Cover?
Benefits vary depending on which Medigap plan you choose. At a minimum, every Supplement plan covers the Part A coinsurance, the first 3 pints of blood in a transfusion, and gives you an extra 365 lifetime reserve days for inpatient hospital care.
The following table lists the benefits for each Medicare Supplement plan:
Since Medigap only pays for services covered by Original Medicare, plans don't offer prescription drug coverage. For that, you need either a standalone Medicare Part D plan or a Medicare Advantage Prescription Drug plan (MA-PD). Remember, though, that you cannot have both Medigap and an Advantage plan.
Medigap Plan C and Medigap Plan F in Illinois
Two Supplement plans are no longer available to new Medicare beneficiaries. If you qualify for Medicare on or after January 1, 2020, you may not join Medigap Plan C or Medigap Plan F.
Comparable coverage is available via Medigap Plan D and Medigap Plan G, which include everything that Plans C and F covered (with the exception of the Medicare Part B deductible).
When Is the Best Time to Join a Medicare Supplement Plan in Illinois?
The best time to join an Illinois Medicare Supplement plan is during your Medigap Open Enrollment Period (OEP). This begins the day you enroll in Original Medicare and lasts for 6 months. And, unlike many states, Illinois requires Medigap insurers to offer coverage to under-65 Medicare beneficiaries, as well. The state also limits how much insurers can charge people who qualify for Medicare due to disability or illness.
The Medigap OEP is one of the few times you have a guaranteed issue right, meaning you cannot be denied coverage. And, if you're age 65 or older, you also cannot be charged a higher premium – even if you have preexisting medical conditions.
If you qualify for Medicare due to a disability, you get a second Open Enrollment Period when you turn 65. Even if you already had a Medigap plan, you get the same 6-month guaranteed issue rights that other over-65 applicants get.
How to Choose a Medigap Plan in Illinois
Medical underwriting means that it's important to consider future healthcare needs when choosing a Medigap plan. You may not be able to get more comprehensive coverage at a later date if you don't qualify for guaranteed issue rights.
Your next concern is cost. Pricing methods include:
- Community rated: These plans charge the same premium regardless of age. Over time, you pay less for these Medigap plans.
- Issue-age rated: Premiums are based on your age at the time you join the plan, although they may rise due to inflation.
- Attained-age rated: Premiums start out low but go up as you get older. These policies are usually the most expensive option over time.
Our Find a Plan tool makes it easy to compare Medigap plans in Illinois. Simply enter your location information and coverage start date to review Medicare plan options in your area.