What Is a Medigap Policy? | Compare Plans
Medigap policies are sold by private insurers to help cover some of Original Medicare’s out-of-pocket costs, which may include full or partial coverage for your Medicare deductibles, copayments and coinsurance.
This chart demonstrates helpful information about the different basic benefits Medigap policies cover. If a percentage is listed, the Medigap plan provides coverage for that percentage of the benefit, and you have to pay what’s remaining.
The following chart helps compare all 10 standardized Medigap plans.
Typically, Medigap policies do not provide coverage for long-term care (such as nursing homes or assisted-living facilities), vision or dental care, hearing aids, eyeglasses, or private-duty nursing.
Buying a Medigap Policy
The best time to purchase a Medigap policy is during your Medigap Open Enrollment Period—which is a one-time-only, six-month period in which you are allowed to purchase Medicare Supplement Insurance sold in your state.
This period begins during the first month that you’re both 65 years old and signed up for Medicare Part B. During your OEP, you cannot be denied a Medigap policy or charged more because of past or current health issues.
Notes to consider: Some states have additional Open Enrollment rights under state law. Medigap Plans D and G effective on or after June 1, 2010 have different basic benefits than Medigap Plans D or G purchased before June 1, 2010. Medigap plans E, H, I, and J are no longer sold, but, if you already have one of these Medigap plans, you can typically continue with it.
You must have Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) to buy a Medigap policy. If you have a Medicare Advantage Plan already but plan to return to Original Medicare, you can apply for a Medigap policy before your coverage expires.
Individuals are responsible for paying the private insurer a premium for the Medigap policy, along with the monthly Part B premium paid to Medicare.
Medicare is made up of several parts and keeping the details straight can get confusing. Below, we answer some common questions surrounding Medicare Supplement Insurance.
Is Medigap the same as a Medicare Advantage(Medicare Part C)?
No. Medicare Advantage is an alternative to Original Medicare that allows you to receive Medicare benefits from a private insurance plan. Medigap supplements Original Medicare by helping you pay for additional healthcare costs you may incur.
Do I pay a monthly premium for Medigap in addition to my Part B premium?
Yes. Medigap plans come with their own premiums, which are determined by the insurance company. You will pay your Medigap premium on top of your Medicare Part B premium.
Do Medigap plan benefits vary from state to state?
No. If you purchase Medigap Plan F in California, the basic benefits of that plan will be the same as a Medigap Plan F policy purchased in Virginia. The price you pay for these policies, however, will likely vary. Also keep in mind that Medigap policies are standardized differently in Massachusetts, Minnesota and Wisconsin.
Do insurance companies have to offer all 10 standardized Medigap plans?
No. However, all insurance companies that sell Medigap plans must sell Plan A. If they sell any other Medicare Supplement Insurance, they must also provide either Plan C or Plan F.
Will my Medigap Plan provide coverage for my spouse?
No. A Medigap policy only provides coverage for one individual. If your spouse needs Medigap coverage, he or she will need to purchase a separate policy.