Supplementing Original Medicare

A Medigap policy (also known as “Medicare Supplemental Insurance”) is private health insurance that supplements Original Medicare. A Medigap policy helps pay some of the health care costs that Medicare doesn’t cover (known as “gaps”). These are costs like co-payments, co-insurance, and deductibles.

If you have Original Medicare and a Medigap policy, Medicare will pay its share of approved amounts for covered health care costs, and your Medigap policy will then pay its share. Medicare does not help you pay for a Medigap policy.

Unlike Medicare Advantage Plans, Medigap policies only supplement Original Medicare. Generally, prescription drug coverage is not included in Medigap policies.

Standardized Policies

Every Medigap policy must follow strict federal and state laws meant to protect you. In most states, companies offering Medigap policies can only sell a “standardized” Medigap policy. There are several types of standardized policies and each is identified by a letter – A through N. Each policy with the same letter must offer the same basic benefits, no matter which company sells the policy.

Helpful Tips

  • You cannot have a Medicare Advantage Plan and a Medigap policy at the same time.
  • You pay a monthly premium to the private health insurance company. You also pay Medicare for your Part B premium each month.
  • A Medigap policy just covers one person. If you and your spouse both want this type of coverage, you will each need to purchase your own policy.
  • You can renew your Medigap policy even if you have health problems. An insurance company cannot cancel your policy as long as you pay your premiums.
  • Generally, Medigap policies do not cover long-term care, vision or dental services, or private-duty nursing.

Purchasing a Policy

You can buy a Medigap policy from any insurance company that has a license to sell policies in your state. But it’s against the law for anyone to sell you a Medigap policy if you have a Medicare Medical Savings Account (MSA) plan.

Health insurance companies can charge different premiums for the exact same policy. When looking at plans, be sure you are comparing Plan A from one insurance company with Plan A from another company.

Let us help clear up the confusion and help you learn about the Medigap plans available in your area. We can walk you through the other plan choices as well. Visit our Find Coverage page to get started or call us at 1-877-470-3108.

Dropping a Medigap Policy

If you want to end your Medigap policy, you must be careful when you do it. You may have to pay a late enrollment penalty for a Medicare Prescription Drug Plan if:

  • You drop your entire Medigap policy and the drug coverage was not creditable; or
  • You go more than 63 days before your new Medicare coverage starts.

Before dropping your Medigap policy, give us a call at 1-877-470-3108, TTY 711. One of our licensed benefits advisors can help you decide the best time to end your policy.

 

Medicare has neither reviewed nor endorsed this information.