Medicare Supplement Plans

Medicare Supplement Insurance also referred to as “Medigap” is government regulated coverage, sold by insurance companies,  designed to provide complimentary coverage to Medicare parts A & B. It is referred to as “Medigap” as it fills in the “gaps” in original Medicare coverage.  Medicare Supplement insurance is optional for you to purchase but if you choose not to buy a plan, you would be exposing yourself to potentially large medical bills 

Medicare Supplement plans are designed to compliment Original Medicare Parts A and B. This means it helps pay some of the health care costs (“gaps”) that Original Medicare does not cover (like co-payments, coinsurance, and deductibles). If you have Original Medicare and a Medigap policy, Medicare will pay its share of the Medicare-approved amounts for covered health care costs. Then your Medigap policy pays its share of the medical bill.

While a Medigap policy is different from a Medicare Part C plan, they can serve similar functions depending on which plan meets your needs the best. You cannot have a Medigap and Medicare Advantage Plan at the same time. You can have one or the other.

Medigap insurance companies in most states can sell “standardized” Medigap policies identified by letters A,B,D,G,K,L,M,& N. (Plans F & C are no longer available to folks born after 1/1/1955). The Medigap Plan Types chart that follows here shows the benefits included in each type of Medigap policy. A Medigap Plan Type G has the most extensive list of benefits. A Medigap Plan Type A has the least covered benefits. Plans F & C are no longer available for individuals born in 1955 and later.

Each company selling a Medigap policy must offer the same benefits, for each type of plan, no matter which insurance company sells it. The prices will vary among companies based on several factors including how they do underwriting. Given that costs vary among companies for the exact same coverage, it is worth shopping around to find the best price for the specific type of Medigap policy that meets your needs.

To summarize and quote from the CMS Medicare Supplement Guide, “ Cost is usually the only difference between Medigap policies with the same letter sold by different insurance companies.”

*NOTE: Doctors CANNOT pick and choose which Medicare Supplement they will accept. There are a few dozen insurance companies offering plans, and if your doctor accepts one, they accept them all, so paying more for the same coverage is unwise.

What else should I know about Medigap?

• Before you can buy Medicare Supplement Insurance (Medigap), you must have Part A and Part B.
• You pay the private insurance company a monthly premium for Medigap in addition to the monthly Part B premium you pay to Medicare. Also, if you buy Medigap and a separate 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.
• A Medigap policy only covers one person. Spouses must buy separate coverage.
• It’s important to compare Medigap policies since the costs can vary between plans offered by different companies for exactly the same coverage, and may go up as you get older. Some states limit Medigap premium costs.

When to buy

• The best time to buy a Medigap policy is during your Medigap Open Enrollment Period. This 6-month period begins the first month you have Medicare Part B (Medical Insurance), and you’re 65 or older. (Some states have additional Open Enrollment Periods.) After this enrollment period, you may not be able to buy Medigap. If you’re able to buy Medigap, it may cost more.
• If you delay enrolling in Part B because you have group health coverage based on your (or your spouse’s) current employment, your Medigap Open Enrollment Period won’t start until you sign up for Part B.
• Federal law generally doesn’t require insurance companies to sell Medigap to people under 65. If you’re under 65, you might not be able to buy the policy you want, or any policy, until you turn 65. However, some states require Medigap insurance companies to sell Medigap policies to people under 65. If you’re able to buy one, it may cost more.