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If you’re worried about covering costs that Original Medicare doesn’t include, Medicare Supplement Insurance (also called Medigap) is designed to protect your wallet. It helps you pay for copays, coinsurance, and deductibles — expenses that would otherwise come out of your pocket.
You can only purchase a Medicare Supplement plan if you’re already enrolled in Original Medicare (Part A and Part B). It does not cover Medicare Advantage (Part C), prescription drugs (Part D), or other government programs.
Your 6-month Medigap enrollment begins once you turn 65 and are enrolled in Medicare Part B. During this window, you can’t be denied coverage or charged more due to health status.
Yes, if you apply during your open enrollment, insurers must cover your pre-existing conditions. If you wait, they may delay coverage or increase your premium.
Factors: location, inflation, medical history, and timing
If you’re concerned about Medicare costs, a Medigap health insurance policy (also called Medigap supplemental insurance or a Medicare supplemental plan) helps pay the “gap” between what Original Medicare (Medicare Parts A and B) pays and what you pay out of your own pocket.
You can get a Medicare Supplement insurance policy through private insurance companies. You can get a Medicare Supplement insurance plan only if you already have Original Medicare. Medigap covers Medicare Part A (hospital insurance) and Medicare Part B (medical insurance), but it does not cover Medicare Part C (Medicare Advantage plans), Medicare Part D (prescription drug plans), or any other private health insurance, Medicaid, Veterans’ Administration benefits, or TRICARE.
Because Medigap policies are regulated by state and Federal laws, the benefits for all the coverage options are the same regardless of insurer. The differences will be in the price, who administers the plan, and which of the 10 options the insurer chooses to offer. Choose a health insurer you trust, and shop around for the best prices.
Medicare Supplement cover some costs not covered by Original Medicare. For example, a 20% co-insurance bill for a doctor visit could be covered with a Medigap plan. All Medicare Supplemental insurance plans must cover standard services. Additional benefits are available with specific plans. All Medicare Supplemental insurance plans must cover:
Your open enrollment for Medigap supplemental insurance begins the first day of the month in which you turn 65 and are covered under Medicare Part B. You have six months to enroll. If you are under 65, check with your state’s Social Security Administration to see if it offers additional open enrollment periods.
“All insurance companies selling a particular Medigap plan type in your area must offer the same coverage, but may offer it at different prices. So, you may want to shop for the best price.”
Medicare Part A and Part B typically cover pre-existing conditions. The same goes for Medicare Supplement insurance. The difference is, a company may be able to refuse to sell you a Medicare Supplement plan in the first place in some cases. As long as you buy a Medicare Supplement plan during the six-month Medicare Supplement Open Enrollment Period, the insurance company cannot refuse to sell you a plan.
The insurance company also can’t charge you more because you have health problems or make you wait for basic benefits to begin. However, you may have to wait up to six months for the Medicare Supplement policy’s benefits to include your pre-existing condition*.
If you apply for a Medicare Supplement insurance plan outside of your Medicare Supplement Open Enrollment Period, the private insurance company may “underwrite” the plan. Underwriting the plan means that you may be subject to a physical exam, and the insurance company can refuse to sell you the plan or they can adjust your premium based on your health status.
Other factors impacting the premium rates of Medicare Supplement can include inflation, geography, medical underwriting (if you did not buy a plan when first eligible), and other discounts. You should check with each specific health insurer to see how it sets Medigap prices before you buy.
*Pre-existing conditions are generally health conditions that existed before the start of a policy. They may limit coverage, be excluded from coverage, or even prevent you from being approved for a policy; however, the exact definition and relevant limitations or exclusions of coverage will vary with each plan, so check a specific plan’s official plan documents to understand how that plan handles pre-existing conditions.
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If you’re worried about covering costs that Original Medicare doesn’t include, Medicare Supplement Insurance (also called Medigap) is designed to protect your wallet. It helps you pay for copays, coinsurance, and deductibles — expenses that would otherwise come out of your pocket.
You can only purchase a Medicare Supplement plan if you’re already enrolled in Original Medicare (Part A and Part B). It does not cover Medicare Advantage (Part C), prescription drugs (Part D), or other government programs.
There are 10 standardized Medigap plans labeled A through N. The right one depends on your health needs, location, and budget. Some states (like MA, MN, WI) offer different versions.
Your 6-month Medigap enrollment begins once you turn 65 and are enrolled in Medicare Part B. During this window, you can’t be denied coverage or charged more due to health status.
Yes, if you apply during your open enrollment, insurers must cover your pre-existing conditions. If you wait, they may delay coverage or increase your premium.
There are three ways that an insurance company can set Medigap premium rates for Medicare Supplement:
Factors: location, inflation, medical history, and timing
