Medicare Supplement Insurance

Yes, Medigap is just another name for Medicare Supplement Insurance. Medicare Supplement Insurance is a mouthful, which makes a short nickname useful!

No, Medicare Supplement Insurance is NOT the same as Medicare Advantage.

• Medicare Supplement Insurance works with Original Medicare (Medicare Parts A and B).
• Medicare Advantage (also called Medicare Part C) is an alternative to Original Medicare that combines the coverage provided under Medicare Part A and B into one plan and may offer other benefits.

No, Medicare Supplement Insurance and Medicare Advantage do NOT work together. You will not be able to buy a Medigap policy if you are enrolled in a Medicare Advantage plan.

There are two main reasons for buying a Medigap policy.

First, Medigap policies can help you control your out-of-pocket costs. Original Medicare does not have an out-of-pocket cap. In addition to the Medicare Part B premiums, you are responsible for your deductible, copays, and coinsurance, and there is no limit to how much you may pay in copays and coinsurance. Medigap plans can help with these out-of-pocket costs, which can make your healthcare expenses more predictable to help you budget accordingly. If your medical costs are high, Medigap can also save you a substantial amount of money.

Second, some Medigap policies offer additional benefits. For example, some Medigap plans provide foreign travel coverage. In addition, the Commonwealth Fund says around 7% of Medigap plans provide dental, vision, or hearing benefits. (If you want more benefits like these, you might be interested in a Medicare Advantage plan instead. Plus, Medigap plans have NOT provided any prescription benefits since 2005. If you need prescription drug coverage, you’ll need to enroll in a Medicare Part D plan or a Medicare Advantage Prescription Drug Plan.)

The best time to enroll in Medigap is during your Medigap Open Enrollment Period. This lasts for six months, beginning when you enroll in Medicare Part B and are aged 65 or older. During this period, private insurance companies that sell Medigap policies cannot deny you coverage or charge you more based on your pre-existing health conditions. You can apply to buy a Medigap policy after your open enrollment period ends, but insurers could charge you more or deny you coverage.

This means you should consider enrolling in a Medigap plan when you become eligible for Medicare if you think you may need one in the future. It also means switching Medigap plans can be tricky. Medicare.gov says you may have a guaranteed issue right to enroll in a Medigap plan under certain circumstances, such as if your Medigap coverage ends through no fault of your own. If you don’t qualify, however, insurers could deny you coverage.

Some states have additional rules that give some individuals more flexibility regarding Medigap enrollment, especially people who are currently enrolled in a Medigap plan and want to switch to a new one. According to Think Advisor, Connecticut, Maine, Missouri, New York, Washington, California, Oregon, Illinois, and Nevada have rules that make it easier for people to switch Medigap plans. If you want to buy a different Medigap policy and your Medigap Open Enrollment Period has passed, check the rules in your state.

Although it is private insurance companies that sell Medigap plans, the plans are standardized. In most states, the available plans are A, B, C, D, F, G, K, L, M and N.

All plans cover Part A coinsurance and hospital costs for up to 365 days after you’ve used your Original Medicare benefits. The following chart shows the differences in other benefits.

*People who become eligible for Medicare after 2020 can no longer purchase Plans C and F.
**Plans F and G have high-deductible options in some states.

The cost of Medigap plans varies. Some plans are available for less than $100 (sometimes significantly less), whereas others cost several hundred dollars. When comparing plan costs, don’t just look at the premium – also look at your expected out-of-pocket costs. Sometimes, you can save money in the long run by choosing a higher premium.