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What are Medicare Supplement and Medigap Plans?

Posted by David Cheatham, November 24, 2020

Once you’ve enrolled in Medicare, you might expect that all of your healthcare needs will be covered. Unfortunately, that’s not always true. Neither Medicare Part A nor Part B cover 100% of your medical expenses, and you could indeed face significant out-of-pocket costs at some point.

If you would like help managing those out-of-pocket expenses, you might consider enrolling in a Medicare Supplement, also known as Medigap Plan. These policies “fill in the gap” by covering expenses such as co-payments and deductibles. Here’s what you need to know:

  • You must be enrolled in Original Medicare in order to enroll in a Medigap plan
  • Medigap supplements Original Medicare but is very different from Medicare Advantage.
  • Medigap policies no longer offer prescription drug coverage (as of 2006). You need a separate policy for that (Part D).
  • You will pay a monthly premium for your Medigap plan in addition to your Part B premium.
  • You can purchase a Medigap policy from any insurance broker in your state that is licensed to sell them.
  • These policies are guaranteed renewable, so your insurance carrier can’t cancel the policy.
  • Medigap policies cover one person, so you and your spouse will need separate policies.
  • Some Medigap policies cover medical care that would not normally be covered under Original Medicare, such as care you receive outside of the US.

 

When you visit a healthcare provider, they will bill Original Medicare insurance (Parts A and B) for services. Original Medicare will pay its normal share, and the Medigap plan will pick up some or all of the rest.”

While Medigap plans can help to reduce unexpected expenses, it would be a mistake to think of them as “plans to cover everything else”. For example, Medigap does not cover dental visits or treatments, eye exams or vision correction, hearing aids, long-term nursing care, or private nursing care. You will still need to plan for those expenses separately.

Medigap plans can be a good option for many people, but every situation is different. Work closely with your Medicare insurance representative to determine the best fit for your healthcare needs and budget.

Need more information on your insurance options?

Contact us online to learn more

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