What are Medigap Plans?

Medicare coverage through Medicare Part A and Medicare Part B will cover many medical expenses for older Americans, but copays, deductibles, and items that aren’t taken care of by Medicare can add up fast. A Medigap policy will pay for these extra expenses, so you don’t have to worry about unexpected medical bills and expensive health care costs.

What Are the Different Types of Medigap Plans?

When you start to look at different types of Medigap insurance, you’ll notice that there are two options to choose from Medicare Supplement insurance and Medicare Advantage insurance. You can choose either of these options, but you can’t enroll in both at the same time. Therefore, it’s smart to learn about Medigap coverage and what it does in comparison to Medicare Advantage so that you can make the right choice.

How Are Medicare Supplement and Medicare Advantage Plans Different?

With Medicare Supplement insurance policies, you keep your Original Medicare plan (Medicare Parts A and B), but you also receive additional insurance coverage. This takes care of Medicare Part A and Part B deductibles, copayments, Medicare Part A and Medicare Part B coinsurance, Medicare Part B excess charges, and other medical expenses, depending on the Supplemental insurance plan that you choose. Your plan will not include the Medicare Part B premium, however; you will have to pay for this separately.

With Medicare Advantage (Medicare Part C), you will transition fully to a private insurance company approved by Medicare. The best Medicare Supplement insurance companies provide all the benefits of Part A and B, aside from hospice care, and may also offer additional benefits to help you save on out-of-pocket costs, such as vision, dental, or prescription drug coverage from a prescription drug plan. Since different private companies offer different benefits, you’ll want to compare all of your options before choosing an Advantage plan.

Does Medigap Offer Prescription Drug Benefits?

Unfortunately, Medigap health plans do not provide coverage for prescription drugs as part of your monthly premium. If you would like this coverage, then you may want to enroll in a Medicare Part D drug plan.

When Can I Change My Medigap Policy?

You can change your Medicare Supplement plan at any time of the year. A Medicare Advantage plan or your Part D drug plan, however, must be changed during the open enrollment period, which takes place between October 15 and December 7 each year.

Will I Be Accepted If I Have a Preexisting Condition?

After you turn 65 and first enter Medicare, you will have a six-month window during which you can enroll in a Medigap policy without medical underwriting related to health conditions. That means that you cannot be denied this health insurance coverage regardless of your current health status or any preexisting conditions you may have. Depending on the state where you currently live, you may also have other opportunities to enroll without medical questions. Talk to one of our Medigap experts to find out more!

Will My Doctor Accept My Medigap Plan?

If your doctor accepts Medicare, then they will also accept your Medicare Supplement Insurance. If you choose a Medicare Advantage plan, however, then you may be restricted to a specific network.

This is one reason why many Medicare beneficiaries choose Medigap Plan F, Plan A, Plan N, Plan G or another Supplemental plan, since they want to have freedom to choose their own doctor’s office, skilled nursing facility or other healthcare providers without worrying about network restrictions for their doctor’s office or hospital costs.

Why Did My Medigap Costs Go Up This Year?

The cost of your Medigap insurance is affected by the medical needs of other people in your insurance company’s different “groups.” Your rates are calculated based on how many premiums come in from your group compared to how many claims are being paid out. If your Medigap group has a larger number of claims, then your insurance company will increase your rates for the following year. Comparing companies to look for the lowest rate or opting for a high-deductible plan will allow you to keep your monthly premiums down, however.

Will My Medigap Insurance Pay a Claim If Medicare Doesn’t?

Medigap insurance only covers Medicare-approved expenses. If Medicare doesn’t pay, then neither will your supplemental policy. If you aren’t sure about what is or is not included, you can talk to an insurance agent or your healthcare provider for guidance.

How Can I Find the Right Medigap Plan For Me?

Now that Medigap has been fully explained, you may be wondering how to choose the right plan for your needs. That’s where My Medigap Plans comes in! We help you compare different Medigap policies for your area. Just use our simple online Medicare Supplement quote tool. Whether you live in Massachusetts, Minnesota or anywhere else in the United States, we can help you find the plan that is right for you. You can also check out medicare.gov for more information about the Medicare program.

Mark Prip

For more than two decades, Mark Prip at My Medigap Plans has been an authority figure in the insurance industry and continues to uphold a mission to provide customers with comprehensive information about Medicare, life, and dental coverage. In addition, his expertise is unmatched - having helped thousands of Medicare beneficiaries choose suitable healthcare plans for themselves - making him stand out above competitors.