Medicare Supplement


A Medicare Supplement Insurance (Medigap) policy, sold by private insurance companies, can help pay for the health care costs that original Medicare does not cover (like copays, coinsurance and deductibles).   If you have original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amounts for covered health care costs, then your Medigap policy will pay its share. The result of the coordination between the two will leave you with very little, if anything, to pay out-of-pocket.

A Medigap policy is different from a Medicare Advantage policy. Medicare Advantage policies replace Medicare, while a Medigap policy works with Medicare to supplement what Medicare does not cover.

Things you need to know about Medigap policies:

  • You must be enrolled in Medicare Parts A & B to purchase a Medigap policy.
  • You pay the private insurance company a monthly premium for your Medigap policy, in addition to the monthly Medicare Part B premium that you pay to Medicare.
  • There is an enrollment window where you can purchase your Medigap policy without medical underwriting (guarantee issue). This window is the 3 months prior to your turning age 65, the month in which you turn 65, and the 3 months following the month in which you turn 65. There are a few other special enrollment events that would grant guarantee issue as well.
  • A Medigap policy only covers one person. You and your spouse will need to apply separately for a Medigap policy.
  • You can buy a Medigap policy from any insurance company that is licensed in your state to sell one.
  • Medigap plans are federally standardized and are the exact SAME plans from company to company that sell them, with the only difference being the premium.
  • Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company cannot cancel your policy as long as you pay the premium.
  • If you have a Medicare Advantage plan, you can apply for a Medigap policy, but make sure you can leave the Medicare Advantage plan before your Medigap policy begins.
  • Medigap plans, unlike Medicare Advantage plans, do NOT restrict you to a specific network of doctors and hospitals. You can use any medical provider that takes Medicare.
  • Medigap plans do not cover prescription drugs. You would need to purchase a Medicare Drug Plan in addition to a Medigap plan.
  • Medigap plans generally do not cover long-term care, vision, dental care, hearing aids, eyeglasses or private-duty nursing.

 

We would be happy to help you to wade through the complexity of your health care needs when you reach Medicare-eligible age.

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