What is Medicare Supplement (Medigap)?
Medicare Supplement Plans are also known as a Medigap plan. These plans provide “gap” coverage to cover your out-of-pocket costs not covered by Original Medicare Part A and B. For example, your 20% coinsurance out-of-pocket obligation that Original Medicare Part B does not cover.
Unlike Medicare Advantage plans, when you purchase Medicare Supplement insurance, you are choosing to continue to stay in and receive your Medicare coverage through Original Medicare Part A and B.
What are the features of Medicare Supplement (Medigap)?
- Your Medicare Supplement plan acts as supplemental private insurance that pays for the “gaps” you owe to your healthcare provider when you use a service. This typically means that you will have limited to no out-of-pocket costs when using healthcare services, since your Medicare Supplement plan will help pay for your out-of-pocket obligations.
- In addition, because you are still enrolled in Original Medicare you can see any doctor who accepts Original Medicare, meaning there are no network restrictions and you do not have to stay in-network as you would with Medicare Advantage.
- The catch for this comprehensive coverage is that you will have to pay a premium for your Medicare Supplement in addition to your Medicare Part B premium.
- There are 10 standardized Medicare Supplement plan types in most states. These plans are identified by letters A through N, and should not be confused with Original Medicare Part A and B.
- Because these plans are standardized – for the same plan type, a plan from Company A provides exactly the same cover as the same plan from Company B.
- Therefore, the only difference when comparing plans is usually the price of the premium.
Other information
For the most popular Medicare Supplement plan types, premiums can range from $90 per month to over $200+ per month, depending on your age, gender, health status and where you live. By paying this premium on top of your Medicare Part B premium, you get comprehensive nationwide coverage with limited to no out-of-pocket costs when you use Medicare-covered services because your Medicare Supplement plan will pay for the ‘gaps’ you are responsible for.
Finally, it’s important to note that you cannot sign up for both a Medicare Advantage plan and Medicare Supplement plan at the same time – you must choose one.
Enrolling in Medicare Supplement
If you are thinking of purchasing a Medicare Supplement plan, it’s important to know that there is typically a 6-month window after you first enroll in Medicare Part B where insurance companies must sell you a policy regardless of your health situation – this is called ‘Guaranteed Issue’.
This 6-month window only happens once and does not renew once it has lapsed. If you do not purchase a Medicare Supplement policy during this 6-month window, you will be required to answer questions about your health history and there is typically no guarantee that an insurance company will sell you a Medigap policy.
