Medigap – What is It and Do I Need It?

August 6, 2018 | Tom Peterson

What happens when your Medicare pays for most of your costs, but not all of your costs? Don’t worry- Medicare Supplement Insurance (Medigap) will pay for the extra costs such as copayments, coinsurance, and deductibles that Medicare may not completely cover

What Is Medicare Supplement Insurance (Medigap)?

It’s a policy that helps pay for some things that Medicare may not completely pay for.  Medigap plans are sold by private insurance companies licensed to offer these plans in your state. Medigap plans are different than Medicare Advantage Plans (like an HMO and PPO).  Medigap policies don’t cover most Part D prescription medications.  If you want drug coverage, you can add standalone Part D plans available in your service area.

Is Medigap Covered in My State?

Most plans are guaranteed renewable plans. Guaranteed Renewable plans are where the benefits stay consistent even though the premiums may change.

Premiums can be set in one of three ways:  Community rated (also called “no age rated”), Issue-age rated (also called “entry age rated”) and attained-age rated.  Contact us to find out if your area is covered and how your premium will be set.

Types of Medigap Plans

Medicare Select: A Medicare Select policy is a Medigap plan that limits the plan to a network of doctors and hospitals.

Standardized: A Medigap policy that has no network and requires no prior authorization for Medicare approved services. If your provider participates in the Medicare program, you are covered for standardized Medigap.

When Should I Buy a Medigap Plan?

There is an open enrollment period that starts the month you turn 65 and enroll in Medicare Part B. During this time, you can buy any Medigap policy sold in your state regardless of your health status. There may be other times you are eligible to receive a guaranteed issue right to enroll in a Medigap plan.

Still have questions on Medigap coverage? This chart from Medicare breaks it down in detail.