Medicare Supplement/Medigap

A Medicare Supplement plan, also known as Medigap, is a type of insurance policy designed to cover costs that Original Medicare (Parts A and B) does not fully cover. These additional costs can include things like copayments, coinsurance, and deductibles.

Here’s a breakdown of what Medicare Supplement/Medigap plans are and how they work:

1. Coverage:

• Cost Sharing: Medigap plans help pay for out-of-pocket expenses that you are responsible for under Original Medicare, such as deductibles, copayments, and coinsurance.
• Additional Benefits: Some Medigap plans also offer benefits not covered by Original Medicare, such as foreign travel emergency coverage, or additional services like discounts on vision, hearing, or dental care.

2. Standardization:

• Lettered Plans: Medigap plans are standardized and labeled with letters (e.g., Plan A, Plan B, Plan F, Plan G, etc.). Each lettered plan offers a different set of benefits, and the coverage for each plan is the same regardless of which private insurance company offers it.
• Benefits: The specific benefits of each lettered plan are set by federal law, so you can expect the same coverage from any insurer offering that plan.

3. Enrollment:

• Eligibility: To buy a Medigap policy, you must be enrolled in Medicare Part A and Part B.
• Initial Enrollment Period: The best time to buy a Medigap policy is during your six-month Medigap Open Enrollment Period, which starts the first month you are 65 or older and enrolled in Medicare Part B. During this period, you cannot be denied coverage or charged higher premiums due to pre-existing conditions.
• Outside Open Enrollment: If you apply for Medigap coverage outside of this period, you may be subject to medical underwriting and could face higher premiums or denial based on your health status.

4. Costs:

• Premiums: You pay a monthly premium for your Medigap policy in addition to your Medicare Part B premium. The cost of Medigap premiums varies based on factors like your age, location, and the specific plan you choose.
• No Network Restrictions: Medigap plans generally allow you to see any doctor who accepts Medicare, without needing a referral or worrying about network restrictions.

5. Limitations:

• No Drug Coverage: Medigap plans do not include prescription drug coverage. If you need help with prescription drugs, you should consider enrolling in a separate Medicare Part D plan.
• Not Available to All: Medigap Plan F and Plan C are not available to new Medicare enrollees as of January 1, 2020, due to changes in legislation. However, those who were already enrolled in these plans before this date can keep them.

In summary, Medicare Supplement plans can help reduce your out-of-pocket expenses for medical services covered by Medicare, offering you more financial predictability and peace of mind. Medicare Supplement/Medigap will not pay unless Medicare pays first.

We are here to help you navigate your options, it's beneficial to work with a local independent, licensed, and certified insurance agent who can provide personalized advice and help you find the right plan for you.