Do I Really Need a Supplement Plan?
Do I Really Need a Supplement Plan?
Who needs it, and who might be okay without it.
“Security is mostly a superstition.” — Helen Keller
If you’ve enrolled in Original Medicare (Parts A & B), you’ve taken a smart first step toward protecting your health in retirement. But you might be wondering:
“Do I really need a Medicare Supplement (Medigap) plan?”
It’s a fair question—after all, Medigap plans aren’t free. But the answer often comes down to one thing: how much risk are you willing to carry on your own?
Let’s explore who truly benefits from a Supplement plan—and who might manage without one.
What Medicare Doesn’t Cover
Original Medicare only covers about 80% of your medical costs, and it does not include an out-of-pocket maximum. This means that if you experience a major illness or hospitalization, there’s no cap on what you could owe.
Here’s what you’re still responsible for under Original Medicare:
The Part A deductible ($1,632 per benefit period in 2025)
Hospital coinsurance for stays over 60 days
The Part B deductible ($240 in 2025)
20% coinsurance for most doctor visits, surgeries, and outpatient care
No cap on total expenses
Who Needs a Medigap Plan?
Medicare Supplement coverage is strongly recommended if:
✅ You have ongoing health conditions or expect to see specialists regularly
✅ You travel often and want access to any Medicare-approved provider nationwide
✅ You want to predict your costs and avoid surprise bills
✅ You dislike dealing with networks, referrals, or prior authorizations
✅ You’d like foreign emergency travel coverage
In short: If you want maximum freedom, flexibility, and financial protection, a Medigap plan is a wise investment.
Who Might Be Okay Without a Medigap Plan?
Some individuals can function well without Medigap—if the circumstances are right:
✅ You’re very healthy with minimal medical needs
✅ You can afford higher out-of-pocket costs if needed
✅ You are enrolled in a Medicare Advantage (Part C) plan with an annual out-of-pocket limit
✅ You qualify for Medicaid or a Medicare Savings Program, which covers some or all cost-sharing
In these situations, you may not “need” Medigap—but you’ll want to re-evaluate each year. Health and income can change quickly.
The Myth of ‘I’ll Just Pay As I Go’
Many people assume they can handle costs as they come. But a single hospital stay, surgery, or series of treatments can wipe out savings quickly—especially since Original Medicare has no cap on how much you might owe.
With Medigap, you get:
Predictable monthly costs
Protection from runaway bills
A sense of financial control during unpredictable health moments
Your Enrollment Window Matters
The best time to enroll in Medigap is during your 6-month Medigap Open Enrollment Period, which starts the month you’re both 65 and enrolled in Part B.
During this time, insurers cannot deny you or charge more for pre-existing conditions. After this window, you may be subject to medical underwriting.
What If I Change My Mind Later?
If you skip Medigap now but want to enroll later, you may be denied based on health history—or charged a much higher premium. That’s why it’s better to lock in coverage when you’re healthy, even if you don’t need much care today.
Think of it like buying a fire extinguisher before the fire—not after.
How KEyO Insurance Services Can Help
At KEyO, we take the guesswork out of Medicare. We’ll help you assess your health history, risk tolerance, travel habits, and budget—then build a customized solution that fits your unique needs. Whether that means going with Medigap, Advantage, or another plan entirely, you’ll feel empowered to make the best decision for your future.
With Trusted Care. Tailored for You., KEyO stands with you—today, tomorrow, and always.
Final Thought:
You may not need a Medigap plan—until you do. And when that moment comes, having one could mean the difference between stress and stability.
