Medicare Supplement Plans

What Is Medicare Supplement Insurance?

Medicare Supplement Insurance, affectionately known as Medigap, is a type of private insurance that bridges the gap between what Medicare covers and the actual medical costs you might incur. Ever looked at a medical bill and felt overwhelmed by terms like copays, coinsurance, and deductibles?

Well, that’s precisely where Medicare Supplement Insurance steps in. By picking up these out-of-pocket costs, Medigap offers a financial safety net, ensuring that unexpected medical expenses don’t derail your budget.

So, if you’re navigating the complexity of Medicare plans and considering if a Medicare Supplement plan is right for you, stick around. Our guide will help you understand the details of these supplement plans, empowering you to make informed decisions about your healthcare.

How Medicare Supplement Insurance Works

Medicare Supplement Insurance, or Medigap, covers the “gaps” in Medicare’s standard coverage. It’s designed to supplement your primary Medicare coverage, but not replace it. To qualify for a Medigap plan, you must be enrolled in Medicare Parts A and B.

Here’s how it works: Medigap swoops in to cover some of the healthcare costs that your primary Medicare doesn’t cover, like coinsurance, copayments, and yearly deductibles. Some Medigap policies even offer coverage for services that standard Medicare doesn’t cover, like medical care when you travel outside the U.S.

There are 10 different Medigap plans – each labeled with a different letter. Each standardized Medigap policy must offer the same basic benefits, no matter which insurance company sells it. This means you can choose a plan that fits your needs and then shop for the insurance company that offers the best rates and customer service.

What Does Medigap Cover?

Medigap is designed to help cover some of the healthcare costs that Original Medicare doesn’t include. Here’s a rundown of the typical expenses and services covered by Medigap:

• Copayments: Copayments are the fixed amounts you pay for healthcare services after you’ve met your deductible. Medigap can help cover these costs, especially for services covered by Original Medicare Part A and Part B.
• Coinsurance: Similar to copayments, coinsurance is the percentage of costs you’re responsible for after you’ve met your deductible. Medigap can help cover these coinsurance costs for services covered by Original Medicare.
• Deductibles: Deductibles are the amounts you must pay out-of-pocket for your care before your insurance kicks in. Medigap can cover the deductibles for services covered by Original Medicare.
• Hospital Stays: Medigap covers hospitalization expenses, aiding with the cost of a semi-private room, meals, general nursing, and drugs as part of your inpatient treatment, and other hospital services and supplies.
• Skilled Nursing Facility Care: Medigap can cover the costs of skilled nursing facility care, including semi-private rooms, meals, skilled nursing and rehabilitative services, and other services and supplies.
• Outpatient Care: Medigap also covers outpatient care, which includes doctors’ services, outpatient hospital visits, and some home healthcare services.

What does Medicare Supplement insurance not cover?

While Medigap policies offer extensive coverage, they do not cover everything. Here are some of the services and benefits typically not covered by Medicare Supplement insurance:

• Long-term Care: Medicare Supplement insurance does not cover long-term care, which includes custodial care in a nursing home, assisted living, or home health care for extended periods.
• Vision or Dental Care: Routine vision or dental care, including eye exams, glasses, dental cleanings, fillings, or dentures, are not typically covered by Medigap policies.
• Hearing Aids: Medigap policies usually do not cover hearing aids or exams for fitting them.
• Private-Duty Nursing: The costs associated with private nursing are not covered by Medicare Supplement insurance.
• Prescription Drugs: Medigap policies sold after January 1, 2006, are not allowed to include prescription drug coverage. If you want prescription drug coverage, you’ll need to join a Medicare Prescription Drug Plan (Part D).

You may need additional insurance or alternate coverage options to cover these services and items. Always remember to discuss your specific needs with a trusted licensed insurance agent or broker like myself when considering a Medicare Supplement policy.

Medigap Plans By Letter

As previously mentioned, there are 10 different Medigap plans, each tagged with a unique letter. These letters range from Plan A to Plan N, and each plan represents a different level of coverage. You may view this in the Medigap Plans by Letter image.


Note that these plans are standardized by the federal government, which means regardless of the insurance company selling the plan, the coverage details remain consistent for each plan type. For example, Plan A from Company X carries the same benefits as Plan A from Company Y.

Each plan offers a unique mix of benefits, allowing you to choose a plan that best suits your personal healthcare needs and budget. Some plans might have more comprehensive coverage than others but may come at a higher premium.

How to buy a Medigap policy

Buying a Medigap policy involves a methodical process that ensures you get the best coverage tailored to your healthcare needs and budget. As an experienced and licensed insurance broker, I am here to assist you in this journey.

Firstly, you need to decide which plan you want. Examine and compare the benefits of each standardized plan. Each Medigap policy, from Plan A to Plan N, offers a unique set of benefits. The key is to understand what each plan covers and determine which one aligns best with your healthcare requirements.

Once you have identified the plan you want, it’s time to pick a policy within your geographical area. Remember, standardized plans mean that the benefits offered under a particular Medigap policy are the same, regardless of the provider. For example, a Plan G policy offers the same benefits whether you buy it from Company X or Company Y. The only difference is the price.

After selecting the policy, your next step is to contact the insurance company with your insurance agent for a quote. Be sure to clarify any doubts you have and understand the terms and conditions fully.

Finally, when you’re completely satisfied and ready, you can proceed to purchase your Medigap policy. This careful approach will ensure that you are taking the right step towards protecting your health and finances. As your trusted broker, I’m always here to provide any necessary guidance and answer any questions you may have.

When Can I Buy Medigap?

The most ideal time to purchase a Medigap policy is during your Medigap Open Enrollment Period (OEP), which starts on the first day of the month when you’re 65 or older and enrolled in Medicare Part B and lasts for six months. During this period, an insurance company can’t refuse to sell you any Medigap policy it offers, charge you more based on your health condition, or make you wait for coverage to start.

However, if you miss the OEP, there may be Special Enrollment Periods (SEPs) under certain situations such as if you move or lose your current insurance. SEPs allow you to buy a Medigap policy outside of your OEP without any health underwriting.

The importance of purchasing a Medigap policy during the OEP cannot be overstated. If you apply for a Medigap policy after your OEP ends, there’s no guarantee that an insurance company will sell you a Medigap policy if you don’t meet the medical underwriting requirements, unless you’re eligible due to a specific situation. Furthermore, if you’re able to buy one, it may cost more due to past health problems. Understanding these enrollment periods and timing your purchase accordingly can help ensure the availability of the Medigap policy you want and potentially save you from higher costs.

Let Us Help

Opting for the guidance of a licensed insurance agent from the very start of your Medigap journey can prove to be an extremely beneficial move. Agents come equipped with an in-depth understanding of the insurance landscape, offering the kind of expertise that can help you navigate through the various plans with ease. They can provide clarity on complex terms and conditions, and help you to compare different plans, ensuring that you choose a policy that tailors well to your personal health requirements.

Additionally, working with a licensed insurance agent doesn’t incur any additional financial burden. Our advice is offered free of charge, meaning you get access to personalized, professional guidance without having to worry about hidden costs or fees.

Moreover, we represent a broad spectrum of insurance companies, which allows us to present you with a wide range of plan options. This extensive selection increases the likelihood of finding a plan that not only meets your health needs but also fits your budget. In essence, by allowing us to assist you from the beginning, you’ll be setting yourself up for an informed, cost-effective, and personally tailored Medigap plan selection process.