Medicare Supplement (Medigap)

Medicare Supplement Medigap

What Is Medicare Supplement (Medigap) Insurance?

A Medicare Supplement (Medigap) insurance, sold by private companies, can help pay some of the healthcare costs that Original Medicare doesn’t cover. As copayments, coinsurance, and deductibles.

If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Your Medigap policy pays its share.

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.

What you need to know about policies

  1. You must have Medicare Part A and Part B.
  2. If you have a Medicare Advantage Plan, you can apply for a Medicare Supplement insurance policy, but make sure you can leave the Medicare Advantage Plan before your insurance policy begins.
  3. You pay the private insurance company a monthly premium for your insurance policy in addition to the monthly Part B premium that you pay to Medicare.
  4. You can buy a Medicare Supplement insurance policy from any insurance company that’s licensed in your state to sell one.
  5. Any standardized Supplement insurance policy is guaranteed renewable even if you have health problems. This means the insurance company can’t cancel your Medicare Supplement insurance policy as long as you pay the premium.
  6. Medicare Supplement insurance 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).
  7. It’s illegal for anyone to sell you a Medigap policy if you have a Medicare Medical Savings Account (MSA) Plan.

Medicare Supplement Policies Are Standardized

Every Medigap policy must follow federal and state laws designed to protect you, and it must be clearly identified as “Medicare Supplement Insurance.” Insurance companies can sell you only a “standardized” policy identified in most states by letters.

All policies offer the same basic benefits but some offer additional benefits, so you can choose which one meets your needs. In Massachusetts, Minnesota, and Wisconsin, Medigap policies are standardized in a different way.

Each insurance company decides which Medigap policies it wants to sell, although state laws might affect which ones they offer. Insurance companies that sell Medigap policies:

  • Don’t have to offer every Medigap plan
  • Must offer Medigap Plan A if they offer any Medigap policy
  • Must also offer Plan C or Plan F if they offer any plan

Keep in mind, that the Medicare Supplement policies cover co-insurance after you’ve paid the deductible (unless the Medigap policy also pays the deductible).

Information obtained from www.medicare.gov

Menu