Medicare Supplement Insurance Explained

What Is Medicare Supplement Insurance?

Medicare Supplement Insurance is commonly called Medigap.

Medigap is private insurance designed to help pay certain out-of-pocket expenses left by Original Medicare.

It works with Original Medicare rather than replacing it.

How Does Medigap Work?

If Medicare approves and pays its share of a covered claim, your Medigap policy generally pays according to the standardized benefits included in your particular plan.

Depending on the Medigap plan, coverage may include some or all of:

Not every Medigap plan covers every category.

Is Medigap the Same as Medicare Advantage?

No.

This distinction is extremely important.

Medicare Advantage replaces Original Medicare as the mechanism through which you receive your Medicare-covered benefits.

Medigap supplements Original Medicare.

You cannot use a Medigap policy to pay Medicare Advantage deductibles and copayments.

You generally choose one structure or the other, not both simultaneously.

Are Medicare Supplement Plans Standardized?

Yes, in most states.

Plans are generally identified by letters such as:

A, B, D, G, K, L, M and N.

A Plan G sold by one insurance company provides the same standardized medical benefits as Plan G sold by another insurance company.

Premiums and company-related factors can differ.

Massachusetts, Minnesota and Wisconsin use different standardized structures.

Does Medigap Include Prescription Drugs?

Modern Medigap policies do not include Medicare Part D prescription coverage.

Someone using Original Medicare and Medigap who wants prescription drug coverage generally purchases a separate Part D plan.

Does Medigap Include Dental, Vision or Hearing?

Standardized Medigap benefits generally do not include routine:

Separate coverage may be available for certain services.

When Is the Best Time to Enroll?

Your federal Medigap Open Enrollment Period generally lasts six months beginning when you are both:

65 or older

and

enrolled in Medicare Part B.

During this period, you generally may purchase any Medigap policy sold to you in your state without being denied because of pre-existing medical conditions.

This federal Medigap enrollment period generally does not repeat every year.

Can I Change Medicare Supplements Later?

Possibly.

Outside protected enrollment or guaranteed-issue situations, an insurer may be permitted to use medical underwriting depending on applicable federal and state law.

That means changing Medigap policies later may not always be guaranteed.

State-specific protections can provide additional rights, so individual circumstances should be reviewed carefully.

Can My Medigap Policy Cancel Me Because I Get Sick?

Standardized Medigap policies are generally guaranteed renewable as long as you pay your premiums and comply with policy requirements.

Your insurer generally cannot cancel your coverage simply because your health changes.

Do Medigap Premiums Increase?

They can.

Your premium can depend on:

You should therefore consider both today's premium and the possibility of future increases.