Medigap: Medicare Supplement Insurance
What is Medigap?
Medigap, also known as Medicare Supplement Insurance, is private health insurance designed to help cover the out-of-pocket costs left by Original Medicare. These costs include copayments, coinsurance, and deductibles. With a Medigap policy, Medicare first pays its share of the approved healthcare expenses, and then your Medigap policy covers its portion.
Medigap is different from Medicare Advantage (Part C). While Medicare Advantage plans provide an alternative way to receive Medicare benefits, Medigap policies work alongside Original Medicare to lower out-of-pocket expenses.
25
States Serving nationwide
17+
Years Of Experience
Standardized Medigap Plans
Medigap policies are standardized and identified by letters A through N. Each policy with the same letter must offer the same core benefits, no matter which insurance company sells it. The main difference between plans is their cost. Some plans cover more expenses than others, so it’s important to compare your options based on your needs and budget.
A few states, including Massachusetts, Minnesota, and Wisconsin, have different standardization rules for Medigap policies. Some states also offer a type of Medigap called Medicare SELECT, which requires you to use specific healthcare providers in exchange for lower costs.
What Medigap Covers
All Medigap policies provide basic benefits such as:
- Medicare Part A coinsurance and hospital costs (for up to 365 extra days after Medicare benefits are used up)
- Medicare Part B coinsurance or copayments
- First three pints of blood for medical procedures
- Hospice care coinsurance or copayments
Some plans offer additional benefits, including:
- Skilled nursing facility coinsurance
- Medicare Part A and Part B deductibles
- Coverage for Part B excess charges
- Emergency healthcare coverage for foreign travel
Medigap vs. Medicare Advantage
Medigap is not a Medicare Advantage plan. If you choose Medigap, you must remain enrolled in Original Medicare (Parts A and B). Unlike Medicare Advantage, which often includes additional benefits like dental or vision coverage, Medigap focuses solely on reducing out-of-pocket medical costs.
Medigap and Prescription Drug Coverage
Medigap policies do not include prescription drug coverage. You should enroll in a separate Medicare Part D plan if you need drug coverage. If you have an older Medigap policy with drug coverage, you must drop it if you enroll in Medicare Part D.
Enrollment and Eligibility
The best time to enroll in Medigap is during your six-month Medigap Open Enrollment Period, which begins when you are 65 or older and enrolled in Medicare Part B. During this time, you have guaranteed issue rights, meaning insurance companies cannot deny you coverage or charge higher premiums due to pre-existing conditions. After this period, you may be subject to medical underwriting, affecting your eligibility or costs.
If you became eligible for Medicare on or after January 1, 2020, you cannot enroll in Medigap Plan C or Plan F. However, if you were eligible before that date, you may still purchase these plans if they are available.
Contact Us
Finding the Right Plan
Comparing Medigap plans is essential to finding the best fit for your healthcare needs. Since all plans with the same letter offer identical benefits, focus on factors like premium costs, financial stability of the insurer, and customer service reputation when making your decision.
