If you’re enrolled in Original Medicare, you may find that it doesn’t cover all your healthcare costs. That’s where Medicare Supplement insurance, also called Medigap plans, comes in.
- Covers gaps in Original Medicare
- Freedom to choose your doctors
- Predictable out-of-pocket costs
- Range of plan options available
These plans are sold by private health insurance companies. They help pay for costs like copayments, coinsurance, and deductibles. With Medigap, you can have more predictable healthcare expenses and greater peace of mind.
What Is a Medicare Supplement (Medigap) Plan?
A Medigap plan works alongside your Original Medicare coverage (Medicare Part A and Part B). Medicare pays its share of your approved healthcare costs, and your Medicare Supplemental insurance pays its share. Unlike a Medicare Advantage plan, which replaces Original Medicare, Medigap only supplements it.
Key Facts About Medigap Plans
Eligibility: You must be enrolled in Medicare Parts A and B to buy a Medigap policy.
One Person Per Policy: Medigap covers just one person. If both you and your spouse want coverage, you’ll each need separate Medigap plans.
- Premium: You will pay a monthly premium for your Medigap policy. This is in addition to your monthly Medicare Part B premium.
- Guaranteed Renewability: As long as you pay your premiums, your Medigap policy will always renew. This is true even if you have health problems, like end-stage renal disease. The health insurance company cannot cancel your policy for health reasons.
- Where to Buy: You can purchase Medicare Supplement plans from any licensed insurance company in your state. Enter your zip code when shopping for plans to see options available in your area.
- Prescription Drug Coverage: Medigap policies sold after January 1, 2006, don’t include prescription drug coverage. If you need drug benefits, you should join a separate Medicare Part D plan.
- Switching from Medicare Advantage: You cannot have a Medigap policy if you are in a Medicare Advantage plan. This rule only changes if you switch back to Original Medicare. You can switch from a Medicare Advantage plan to a Medigap plan at certain times of the year. Just remember to leave your Medicare Advantage plan first.
What Do Medigap Plans Cover?
Medigap plans can help pay costs that Original Medicare doesn’t fully cover, such as:
- Part A hospital coinsurance and hospital costs
- Part B coinsurance or copayments
- Blood (first 3 pints)
- Skilled nursing facility care coinsurance
- Part A hospice care coinsurance or copayment
- Part A and Part B deductibles (depending on plan type)
- Emergency healthcare during foreign travel
Each plan has standardized benefits, but costs and availability can vary by zip code and insurance company. It’s important to compare Medicare supplement plans to find the right fit for your needs and budget.
How to Choose a Medigap Plan
When choosing a Medigap policy:
- Compare different Medicare Supplement plans offered by licensed insurance companies in your state.
- Review the monthly premium, covered benefits, and potential out-of-pocket costs.
- Consider if you plan to travel or if you have specific healthcare needs.
Our team at O’Neal Insurance Group can help you understand your choices. We can compare Medigap plans to find the best coverage for you.
Need help choosing a Medigap plan? Contact O’Neal Insurance Group today for personalized assistance and expert advice on Medicare Supplemental insurance. We’re here to make Medicare simple and help you find a plan that fits your healthcare needs.
Frequently Asked Questions About Medicare Supplement Insurance (Medigap)
What is the difference between Medigap and Medicare Advantage plans?
Medigap plans help pay out-of-pocket costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. Medicare Advantage plans (Part C) replace Original Medicare with a private plan. Medigap only works with Original Medicare—not Medicare Advantage.
When can I enroll in a Medigap plan?
The best time to buy Medicare Supplement insurance is during your Medigap Open Enrollment Period. This six-month period starts the month you’re both 65 or older and enrolled in Medicare Part B. After this period, you may face medical underwriting.
Can I have Medigap and Medicare Advantage at the same time?
No. It’s illegal to have a Medigap plan if you’re enrolled in a Medicare Advantage plan, unless you’re switching back to Original Medicare. Always make sure you leave your Advantage plan before starting a Medigap policy.
Do Medigap plans cover prescription drugs?
No. Medigap plans sold after 2006 don’t include drug coverage. If you need prescription benefits, you’ll need to enroll in a separate Medicare Part D plan.How do I choose the right Medigap plan?
Compare benefits and premiums of different Medicare supplement plans available in your zip code. Consider your healthcare needs and budget. Licensed agents at O’Neal Insurance Group can help you compare plans and find the best option.
Related Pages
- Las Vegas Medigap Plans
- Chicago Medigap Plans
