Medicare Supplement Insurance, often called Medigap, is a type of private health insurance that helps cover costs that Original Medicare (Part A and Part B) doesn't pay. These include expenses like copayments, coinsurance, and deductibles. You must have Medicare Part A and Part B to buy a Medigap policy.
Medicare Supplement Insurance, also known as Medigap, is a private health insurance policy that helps pay for some of the "gaps" in Original Medicare (Parts A and B). This includes costs like deductibles, copayments, and coinsurance.
No. A Medicare Supplement plan works with Original Medicare, while a Medicare Advantage plan (Part C) is an alternative way to get your Medicare benefits. You cannot have both a Medicare Supplement plan and a Medicare Advantage plan at the same time.
All Medigap plans cover some or all of the Medicare Part A and B coinsurance and copayments, as well as the first three pints of blood for a transfusion. Depending on the plan, they may also cover the Part A deductible, skilled nursing facility coinsurance, and foreign travel emergency care.
Medigap plans generally do not cover services like long-term care, vision or dental care, hearing aids, or private-duty nursing. They also do not cover prescription drugs.
To get prescription drug coverage, you must enroll in a separate Medicare Part D Prescription Drug Plan.
There are up to 10 standardized Medigap plans, identified by the letters A, B, C, D, F, G, K, L, M, and N. Each plan with the same letter offers the same basic benefits, regardless of the insurance company.
Choosing a plan depends on your health needs and financial situation. You should compare the benefits of the different lettered plans and then compare the premiums offered by different insurance companies for the same plan letter.
The best time to buy a Medigap plan is during your six-month Medigap Open Enrollment Period. This period begins the first month you are both age 65 or older and enrolled in Medicare Part B.
During your Medigap Open Enrollment Period, an insurance company cannot deny you a plan or charge you more based on pre-existing health conditions. Outside of this period, insurance companies may use medical underwriting and can deny you a policy or charge you higher premiums, unless you have a guaranteed issue right.
Guaranteed issue rights are special situations that allow you to buy a Medigap policy outside of your open enrollment period without an insurance company using medical underwriting. This can happen if you lose other health coverage or if you move out of your Medicare Advantage plan's service area.
The cost varies based on several factors, including the plan you choose, your location, and the insurance company's pricing method. Some plans can be as low as $30-$40 per month, while more comprehensive plans can cost over $200 per month.
There are three main ways companies price their premiums:
No. Medigap plans work with Original Medicare, which has no network restrictions. You can see any doctor or visit any hospital that accepts Medicare.
Yes. You must continue to pay your Medicare Part B premium in addition to the monthly premium for your Medigap policy.
No. Medigap policies only cover one person. If both you and your spouse want coverage, you must each buy your own policy.
High-deductible plans have lower premiums but require you to pay for your Medicare-covered costs (up to a set deductible amount) before the plan begins to pay.
Medicare SELECT is a type of Medigap policy that may require you to use specific network hospitals and, in some cases, doctors to receive full benefits.
Plan F offers the most comprehensive coverage, paying for the Part B deductible. However, it is only available to those who became eligible for Medicare before January 1, 2020. For those who became eligible on or after this date, Plan G is the most comprehensive option, covering all the same benefits as Plan F except for the Part B deductible.
Medicare pays its share of the approved amount for covered health care costs first. Then, your Medigap policy pays its share.
You can apply to switch plans at any time, but if you are outside of your Medigap Open Enrollment Period or do not have a guaranteed issue right, the insurance company can use medical underwriting and may deny your application.
