Medicare Supplement Frequently-Asked Questions

What Is a Medicare Supplement?
Medicare Supplement is a supplemental health insurance policy designed to fill the gaps in Medicare coverage. These are regulated plans sold by private insurance companies that can be purchased only by Medicare beneficiaries not already enrolled in Medicare Advantage. Find more in the Medicare Supplement 101 section of this website.

What Does It Offer?
A Medigap policy offers reimbursement for out-of-pocket health service costs not covered by Medicare. These costs are comprised largely of the beneficiary’s share of his/her medical costs. For example, a Medigap policy might cover the Part A deductible, the Part B deductible, the Part B outpatient co-insurance of 20% of allowed charges, and other costs.

What Medigap Policies Are Available?
There are 12 standard “Medigap” plans available in the United States. There is an entire section devoted to the available Medigap Plan Types on MedicareSupplement.com with further information.

What Is Open Enrollment?
In most states, there is an Open Enrollment period during which you cannot be denied for Medicare Supplement insurance, regardless of your health condition. Because of this benefit, your ideal time to buy Medicare Supplement coverage is during the Open Enrollment period. Note, however, that in certain states such as New York, you can purchase a Medigap policy at any time when you are enrolled in Medicare.

How Do I Choose A Medigap Policy?
Medigap Plans A through N are standardized and you read summaries of their coverage.
In choosing which Medigap policy, you need to decide what coverage you want. Different plans provide different levels of coverage. For example, Plans C, F and J pay for your Medicare Part B deductible, while the other plans do not. Once you decide which plan you want, you’ll able to compare the premium costs across insurance companies.

• Frequency of Billing: Some companies bill the premium each month, or each quarter or once a year.
• Ease of Claims Processing: Some Medigap companies have integrated their computer systems with the computer systems at Medicare, for your claim to be more easily processed
• Level of Customer Service
• Overall Reputation of Insurance Company
• Participation of Your Primary Care Physician

What Paperwork Will I Receive From My Insurer?
After a claim is made, your insurance company must send you an Explanation of Benefits to prove that it paid its portion of your claims for your health benefits. Combined with the Medicare Summary Notice (MSN) which you receive from Medicare, you’ll have the full information about how your Medicare claim was processed by both Medicare and your insurance company.

How Am I Protected After I’m Enrolled in a Medicare Supplement?
All Medicare Supplement policies are guaranteed to be renewable, even if you experience health problems after you’re enrolled. The insurer cannot refuse to renew your coverage unless you fail pay the premiums or the insurer can show that you misrepresented yourself on your application.

You can switch standard “Medigap” policies whenever you need a different coverage levels. For example, you can arrange to purchase a Plan F, for example, if you find plan A doesn’t provide enough of the coverage you need. Important: If you are planning to switch, do not cancel your existing plan until your new plan is in force.

Where Can I Get Help In Choosing a Medicare Supplement Policy?
You can find free assistance in choosing a Medigap policy from a licensed health insurance agent in your state of residence. In addition to commercial health insurance agencies, every state has a non-profit State Health Insurance Program staffed by volunteers who can also provide free counseling services.

Should I Buy a Medicare Supplement if I Have Existing Group Coverage?
If you are over 65 but still have existing group coverage, you may choose to wait to enroll in Medicare Part B. Without Part B, there’s no need for a Medicare Supplement. When your employer coverage ends, you’ll get a chance to enroll in Part B without a late enrollment penalty which means your Medigap open enrollment period will start when you’re ready to take advantage of it. If you enrolled in Part B while you still had the employer coverage, your Medigap open enrollment period would start, and unless you bought a Medigap policy before you needed it, you would miss your open enrollment period entirely.