The Medigap program, also called Medicare Supplement Insurance, is designed to close the distance between your full medical bill and the portion covered by your insurance company. Medigap policies don’t operate within the lines of specific hospitals and networks. They cover the parts of a medical bill, such as co-pays and deductibles, skilled nursing care or foreign travel exchange, that aren’t part of your Original Medicare coverage.
The Major Types of Medigap Plans
Medigap plans are sold by private insurance companies, and in most states, they come sorted into 10 standard benefits packages from plan A to N.
All these packages cover up to a year of hospital costs and coinsurance after your Part A Medicare benefits have come to an end. After that, different packages cover differing percentages of certain kinds of health care costs, including:
- Part or all of Medicare Part B coinsurance and co-payments
- Part or all of Part A coinsurance and co-payments for hospice care
- In some cases, part or all of the coinsurance for a skilled nursing facility
- Often, part or all of the deductibles for Medicare Part A
- More rarely, deductibles and extra charges for Medicare Part B
- In many cases, up to 80% of foreign exchange travel plan costs, up to their plan limits
Of the major options for Medigap plans, the most popular choices are plans C and F, which provide the most comprehensive coverage. A Medigap policy will generally not provide prescription drug coverage.
Who Is Eligible for a Medigap Plan, and When?
Medigap policies are available to people who already have Medicare Part A and Part B (covering hospital and physician services respectively). Holders of Medicare Advantage plans aren’t eligible for Medigap plans. If you’re eligible, the first step in looking for the right Medicare supplement insurance is to know your enrollment window.
Open enrollment, during which any Medigap policy can be purchased at the same price a person in good health pays, is typically six months from your 65th birthday or six months from the date of enrollment with Medicare Plan B. After that window, getting coverage may prove more difficult.
Why Your Choice of Medigap Policy Matters
Finding the right policy isn’t always easy. Medigap providers typically aren’t rated by consumers in the same ways that Medicare Advantage plans tend to be. Medigap does most of its work in the background, and the basic benefits are the same no matter which private insurers are offering a specific benefits package.
Still, your provider matters because they may approach premiums in different ways. Premiums may be community-rated, issue-age rated or attainment-age rated — each of which has different implications for long-term costs.
How to Choose a Medigap Policy
The easiest way to find quality Medigap plans is to search for Medigap carriers in your state or region using a consultation site like Medicare Planning of America. We can provide you with the advice and guidance you need to understand the complexities of Medigap and make a choice that will serve you in the long term.