top of page

Medicare Supplemental Insurance

Medigap Insurance

A Medicare supplemental (Medigap) insurance, sold by private companies, can help pay some of the health care costs that  Original Medicare doesn’t cover, like co-payments, coinsurance, and deductibles.  Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S.  If you have Original Medicare and you buy a Medigap policy, it will pay its share of the Medicare-approved amount for covered health care costs.  Then your Medigap policy pays its share.

medical-insurance.jpg

8 things to know about Medigap policies:

​

  1. You must have Medicare Part A and Part B.

  2. A Medigap policy is different from a Medicare Advantage Plan.  Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.

  3. You pay the private insurance company a monthly premium for your Medigap policy.  You pay this monthly premium in addition to the monthly Part B premium that you pay to Medicare.

  4. A Medigap policy only covers one person.  If you and your spouse both want Medigap coverage, you'll each have to buy separate policies.

  5. You can buy a Medigap policy from any insurance company that's licensed in your state to sell one.

  6. Any standardized Medigap policy is guaranteed renewable even if you have health problems.  This means the insurance company can't cancel your Medigap policy as long as you pay the premium.

  7. Some Medigap policies sold in the past cover prescription drugs.  But, Medigap policies sold after January 1, 2006 aren't allowed to include prescription drug coverage.  If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D).  If you buy Medigap and a Medicare drug plan from the same company, you may need to make 2 separate premium payments.  Contact the company to find out how to pay your premiums.

  8. It's illegal for anyone to sell you a Medigap policy if you have a Medicare Advantage Plan, unless you're switching back to Original Medicare.

Signing a Contract

Medigap policies generally don’t cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.

​

Some types of non-Medigap insurance plans include:

​

  • Medicare Advantage Plans (like an HMO, PPO, or Private Fee-for-Service Plan)

  • Medicare Prescription Drug Plans

  • Medicaid

  • Employer or union plans, including the Federal Employees Health Benefits Program (FEHBP)

  • Tricare

  • Veterans’ benefits

  • Long-term care insurance policies

  • Indian Health Service, Tribal, and Urban Indian Health plans 

If you decide to drop the entire Medigap policy (not just the drug coverage), you need to be careful about the timing.  For example, you may want a completely different Medigap policy (not just your old Medigap policy without the prescription drug coverage), or you might decide to switch to a Medicare Advantage Plan that offers prescription drug coverage.
Doctor Office
If you drop your entire Medigap policy, and the drug coverage wasn’t creditable or you go more than 63 days before your new Medicare coverage begins, you have to pay a late enrollment penalty for your Medicare Prescription Drug Plan, if you choose to join one.

Source: 

https://www.medicare.gov/supplements-other-insurance/whats-medicare-supplement-insurance-medigap

Book a Free Phone Consultation Now

bottom of page