Jane Dotson
Medicare Supplement Insurance, also known as Medigap, is extra insurance that can be purchased from a private health insurance company to help pay for out-of-pocket costs not covered by Original Medicare, such as coinsurance, copayments, and deductibles. When choosing a Medicare Supplement Insurance plan, it is important to consider your current and future healthcare needs and select a plan that meets your specific requirements. This supplemental insurance is available to individuals aged 65 and older enrolled in Medicare Parts A and B and, in some states, to those under 65 eligible for Medicare due to disability or end-stage renal disease. The best time to enroll is during the six-month open enrollment period that begins when you turn 65 and are enrolled in Medicare Part B. You can purchase a Medigap policy from any licensed insurance company in your state, and it is important to compare the benefits of each plan to ensure you are getting the coverage you need.
| Characteristics | Values |
|---|---|
| What is Supplemental Medicare Insurance? | Extra insurance to help pay your share of out-of-pocket costs in Original Medicare. |
| When to buy | During the Medigap Open Enrollment Period. |
| Who can buy? | Individuals aged 65 and older enrolled in Medicare Parts A and B. In some states, those under 65 with eligibility due to disability or end-stage renal disease can also buy. |
| Where to buy | From any insurance company licensed in your state to sell the plan. |
| How to buy | Compare the benefits of each lettered plan, decide on the benefits you need, and select the plan that meets your needs. You can apply online or by phone. |
| Additional Information | Plans A through G generally provide benefits at higher premiums with limited out-of-pocket costs compared to Plans K through N. |
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What You'll Learn
Understanding Medigap/Medicare Supplement Insurance
Medicare Supplement Insurance, also known as Medigap, is extra insurance you can buy from a private health insurance company. It helps cover your share of out-of-pocket costs in Original Medicare. Medigap policies are standardised and regulated by federal and state governments, and they must be clearly identified as "Medicare Supplement Insurance".
When you buy a Medigap policy, you must already have Medicare Part A and Part B, and you will need to pay the monthly premium for Part B as well as a premium to the Medigap insurance company. Your Medigap policy is guaranteed renewable as long as you pay your premium, and your coverage will continue year after year. Medigap policies follow federal and state laws, which are designed to protect you, and it's important to be aware of illegal practices by insurance companies when shopping for a policy.
There are 10 Medigap plan options, designated by letter: A, B, C, D, F, G, K, L, M, and N. Every plan with the same letter designation must include the same coverage, but premiums can vary from company to company. Some Medigap policies also cover extra benefits not covered by Medicare, such as coinsurance costs for skilled nursing facilities and hospice care, excess charges from doctors who don't accept assignments, and foreign travel health care emergencies.
The best time to buy a Medigap policy is during your Medigap Open Enrollment Period if you're 65 or older. During this time, insurers must offer you all the Medigap policies available in your area at the best rates for your age. You can also buy a Medigap policy at any time after signing up for Medicare Part A and Part B, but insurers in most states can reject you or charge more for pre-existing medical conditions unless you apply at certain times. To buy a Medigap policy, you should compare the benefits of each lettered plan and decide which benefits you need. Then, select the plan that meets your needs and find insurance companies selling that plan in your state.
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Comparing plan benefits and costs
Medicare Supplement Insurance, also known as Medigap, helps cover certain out-of-pocket costs associated with Original Medicare (Parts A and B). Medigap policies come in 10 standard plans, with 2 high-deductible plan options, but the specific plans available to you will depend on your situation and state.
When comparing Medigap plans, it's important to note that the benefits within each plan are standardized, meaning that the benefits for a specific plan are the same no matter which insurance company sells it. The premium amount is typically the only difference between policies with the same plan sold by different companies. Therefore, it is important to compare plans with the same letter, such as comparing Plan G from one company with Plan G from another.
Medigap plans with higher premiums tend to offer more coverage, while plans with lower premiums may require you to pay a larger share of the costs yourself. For example, Plans K and L specify how much they will pay for approved services before you meet your out-of-pocket yearly limit and Part B deductible, after which they will pay 100% of your costs for approved services. Plan N, another popular option, offers lower premiums in exchange for some cost-sharing, but it does not cover excess charges.
To find a Medigap plan, you can search online at Medicare.gov using your ZIP code to compare plans and their estimated costs in your area. You can also refer to the Medigap comparison chart published by the Centers for Medicare and Medicaid Services, which outlines the benefits covered by each plan type. Additionally, you can call your State Health Insurance Assistance Program (SHIP) or your State Insurance Department to discuss your options.
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Eligibility and enrolment periods
Medicare Supplement Insurance, also known as Medigap, is an extra insurance policy that can be purchased from a private health insurance company. It helps cover some of the out-of-pocket costs not covered by Original Medicare, such as coinsurance, copayments, and deductibles.
Eligibility and Enrollment Periods
Medicare Supplement Insurance is available to individuals aged 65 and older enrolled in Medicare Parts A and B. In some states, individuals under 65 who are eligible for Medicare due to disability or End-Stage Renal Disease may also be eligible for Medicare Supplement Insurance.
The best time to enroll in a Medicare Supplement Insurance plan is during your Open Enrollment Period. This period starts in the first month that you are 65 or older and enrolled in Medicare Part B, and it lasts for six months. During this time, you cannot be turned down for a Medigap policy, regardless of any pre-existing health conditions.
After your Open Enrollment Period ends, insurance companies are not required to sell you a Medigap policy, except in specific circumstances. These circumstances may include guaranteed issue periods, such as when you have certain life changes or lose previous coverage.
It is important to note that not all plans are offered in every state, and the availability of plans may vary among insurance companies. Additionally, the monthly premiums for Medicare Supplement Insurance plans can differ, and some plans may offer higher benefits with limited out-of-pocket costs, while others provide similar benefits at lower premiums but with higher out-of-pocket expenses.
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Choosing an insurance provider
When choosing an insurance provider for Medicare Supplement Insurance (Medigap), there are several things to consider. Firstly, it is important to compare the benefits of each lettered plan (e.g., Plan G or Plan K) and select the one that best meets your current and future healthcare needs. Think about the specific benefits you require, as you may not be able to switch policies later. Remember that Medigap policies do not typically cover long-term care, vision, dental, hearing aids, private-duty nursing, or prescription drugs.
Once you have decided on a plan, you can choose an insurance company that offers that plan and is licensed to sell it in your state. Keep in mind that not all plans are available in every state, and even if a plan is offered in your state, not all insurance companies will sell policies for it. You can contact your local State Health Insurance Assistance Program (SHIP) to get free help in choosing an insurance company in your area. They may also have a Medigap rate comparison shopping guide for your state.
When comparing insurance providers, be sure to compare the costs of the same lettered plan offered by different companies, as the benefits provided are standardized and should be the same across companies. The only difference between Medigap policies sold by different insurance companies is typically the cost. Additionally, ask for an official quote from the insurance company and carefully review the summary of your Medigap policy before purchasing. Remember that after your Medigap Open Enrollment Period ends, insurance companies are not obligated to sell you a Medigap policy unless you qualify under specific circumstances.
Finally, be aware of illegal practices by insurance companies and protect yourself when shopping for a Medigap policy. For instance, the policy must clearly identify itself as "Medicare Supplement Insurance" on the front. If you encounter any issues or delays in receiving your Medigap policy or card, contact your insurance company and, if necessary, your State Insurance Department.
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Getting help and avoiding illegal practices
Medigap is extra insurance you can buy from a private health insurance company to help pay your share of out-of-pocket costs in Original Medicare. It is important to be vigilant and protect yourself from illegal practices by insurance companies when shopping for a Medigap policy.
Firstly, be aware of health care fraud, which can be committed by medical providers, patients, or others who intentionally deceive the healthcare system for illegal benefits. This can take many forms, including identity theft, impersonating healthcare professionals, diversion of legal prescriptions, doctor shopping, double billing, and more. Protect your health insurance information and do not provide it for "free" services, as this could be fraudulently charged to your insurance company.
When considering a Medigap policy, ensure that the insurance company is licensed to sell that specific policy in your state. Contact your State Insurance Department to check for any complaints and to ensure the policy can be sold in your state. You can also contact your local State Health Insurance Assistance Program (SHIP) to get free help choosing an insurance company in your area and ask for a Medigap rate comparison shopping guide.
Be aware of illegal practices such as claiming to be a Medicare representative, selling a policy that cannot be legally sold in your state, asking questions about your family history or requiring genetic testing, or suggesting that the policy is approved or recommended by the federal government.
If you suspect any illegal activity or have concerns about your Medigap policy, you can report health care fraud to the FBI's Internet Crime Complaint Center (IC3) or contact your State Insurance Department for further assistance.
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Frequently asked questions
Medicare Supplement Insurance, also known as Medigap, is extra insurance that helps pay for out-of-pocket costs in Original Medicare.
Medicare Supplement Insurance is available to those aged 65 and older enrolled in Medicare Parts A and B. In some states, it is also available to those under 65 who are eligible for Medicare due to disability or End Stage Renal Disease.
The best time to enroll is during your Open Enrollment Period, specifically the six-month period that starts the first day of the month in which you turn 65 and are enrolled in Medicare Part B.
Compare the benefits of each lettered plan and consider your current and future healthcare needs. Decide which benefits you need, keeping in mind that you might not be able to switch policies later. Select a plan that meets your needs and find licensed insurance companies selling that plan in your state.
You can apply for a Medicare Supplement Insurance plan online or by phone. Contact your local State Health Insurance Assistance Program (SHIP) to get free help choosing an insurance company in your area. Once you've selected a company, contact them and fill out the application.
