Medigap: The Basics

What Is Medicare Supplement Insurance?

Also known as Medigap, Medicare Supplement Insurance helps cover health care costs that Original Medicare does not cover. This includes things, such as deductibles, coinsurance, copayments and traveling outside of the US. This is different than a Medicare Advantage Plan. Medicare Advantage (MA) is a plan that gives you access to more Medicare benefits, while Medigap supplements your already existing Medicare benefits.

Things to Keep in Mind:

  1. You cannot have an MA Plan AND a Medicare supplement policy at the same time. However, if you can leave your Medicare Advantage Plan before your Medigap policy begins, you can apply.
  2. You must already have Medicare Part A and Part B (Original Medicare) before applying for a supplement.
  3. There will be 2 premiums to pay each month if you get a Medicare Supplement policy, one to Medicare for parts A and B, and the other to the private insurance company for your Medigap policy.
  4. You are guaranteed renewal with any standardized Medigap policy regardless of your health. They cannot be cancelled as long as you pay your premium.
  5. A Medigap policy can only cover one person. Spouses will have to buy separate policies if they both wish to purchase Medicare Supplement.
  6. Medicare Supplement policies do not cover prescription drugs. You can join a Medicare Prescription Drug Plan (Part D) if you want this coverage.
  7. Medigap policies usually don’t cover vision or dental, long-term care, or private-duty nursing.
  8. Your open enrollment period is six months from the first day of the month you turn 65 (as long as you are signed up for Medicare Part B), or within six months from signing up for Medicare Part B.
  9. If you DO NOT purchase during your open enrollment period, or have a pre-existing health condition, your issuer may withhold coverage for out-of-pocket costs for that condition for up to 6 months. After this period, they cannot withhold coverage.
  10. After purchasing a new policy, you have 30 days to review it and see how it fits your needs. Within this period, you can cancel for a full refund.

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