Medigap plans, also known as Medicare Supplement Insurance plans, can help cover some of the out-of-pocket health care costs that aren't paid for by Original Medicare (Part A and Part B). These costs can include deductibles, copayments, coinsurance and other expenses. If you are at least 65 years old and are enrolled in Medicare Part A and Part B, you can consider purchasing a Medicare Supplement Insurance plan.
10 Standardized Medigap Plan Types
Medicare Supplement Insurance plans are available in most states, sold by private insurers that have been approved by the U.S. government. Most states offer 10 standardized Medigap plan types (Massachusetts, Minnesota and Wisconsin have plans that are standardized differently from the other states).
Each of the 10 types of standardized Medigap policies must offer at least four basic benefits that cover the costs of:
- Part A coinsurance for hospital care (and an additional 365 days for hospital stays)
- Part A coinsurance or copayment for hospice care
- Part B coinsurance or copayment
- Three pints of blood
If you receive Original Medicare health insurance benefits and buy a Medigap policy, your Medicare plan will first cover its share of costs. Your Medicare Supplement Insurance plan will then pay its share. Assuming that you’re paying your Medigap premiums on time, the insurance company is required to renew your policy, regardless of any health issues.
Use the chart below to compare the basic benefits of each type of Medicare Supplement Insurance plan.
When Can Medicare Beneficiaries Buy Medigap Policies?
Your first — and best — opportunity to buy a Medigap plan is during your six-month Medigap open enrollment period. During your open enrollment period, insurance companies can’t deny you coverage or charge you more for your premiums due to any health issues or pre-existing conditions. Your open enrollment period begins when you’re both 65 and are enrolled in Medicare Part B.
You may be able to purchase a Medigap plan if you’re under 65 and receive Medicare benefits due to a disability. Not every state requires insurance companies to sell Medigap policies to people under 65. Find out more by contacting your local SHIP office.
If you're 64.5 or older and ready to start comparing Medigap quotes, contact a licensed agent today at 888-264-0148.