Medicare Supplement Insurance (also known as Medigap) is Private health insurance that can help pay some of the cost-sharing expenses left behind by Original Medicare.
Medigap Eligibility Requirements
To be eligible for a Medigap plan:
- You must be age 65 or older and enrolled in Medicare Part B.
- You can't have a Medicare Advantage or Medicare Medical Savings Account (MSA) Plan
In some states, there are laws requiring insurance companies to sell Medigap plans to Medicare beneficiaries under 65, but federal law doesn't require it.
When Can You Buy a Medigap Plan?
The best time to buy a Medigap policy is when you first become eligible, during your 6-month Open Enrollment Period (OEP), which begins the day you are both 65 or older and enrolled in Medicare Part B. During your OEP, insurance carriers must allow you to enroll in any plan you choose, regardless of medical history or pre-existing conditions. But keep in mind: once your open enrollment window passes, you may be subject to medical underwriting or be denied coverage altogether.
The same OEP applies to all beneficiaries, so if you're younger than 65 and covered under Medicare because of a disability, you may not be able to purchase the policy you want (or any policy for that matter) until you turn 65.
How It Works
Medicare Part A and Part B cover various hospital and medical services, but beneficiaries are generally responsible for paying cost-sharing expenses such as deductibles, coinsurance, and copayments. A Medigap plan can help cover these, along with other benefits not covered by Medicare, such as extended hospitalization costs, skilled nursing facility care, and medical care outside of the U.S.
If you have a Medigap policy, Medicare will pay its share of covered health costs first, and then your Medigap policy will pay its share.
Medigap Plan Comparison
Insurance companies can only sell "standardized" Medigap policies, meaning companies must offer same basic benefits for same-type policies. It's important to compare policies between companies because costs can vary widely, even for the same benefits.
In most states, there are 10 different plan options to choose from. Each plan type is identified by a letter of the alphabet, and each covers a different variation of health care costs left by Original Medicare. The following chart enables you to compare the 10 standardized and defined Medigap plans side by side.