Medigap
Medicare Supplement (Medigap) Plans
Medigap policies work alongside Original Medicare to help pay remaining healthcare costs, offering maximum freedom and predictable out-of-pocket expenses.
Important Distinction
Medicare Supplement (Medigap) and Medicare Advantage are mutually exclusive. You cannot have both. Medigap pays second to Original Medicare, whereas Medicare Advantage replaces Original Medicare entirely.
What is a Medicare Supplement?
Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medicare Supplement Insurance policy, sold by private companies, can help pay some of the remaining health care costs, like copayments, coinsurance, and deductibles.
What do Medigap plans cover?
Medigap plans are standardized by the federal government. This means a "Plan G" from one company has the exact same core benefits as a "Plan G" from another company. The only difference is the premium you pay and the customer service of the company. Benefits typically include:
- Part A coinsurance and hospital costs.
- Part B coinsurance or copayments.
- Blood (first 3 pints).
- Part A hospice care coinsurance or copayment.
- Skilled nursing facility care coinsurance.
- Foreign travel emergency coverage (up to plan limits).
What to Consider Before Choosing
- Higher Monthly Premiums: You will pay a monthly premium for your Medigap policy (in addition to your Part B premium). These premiums can increase as you get older.
- No Prescription Drug Coverage: Medigap policies sold today do not cover prescription drugs. You will need to buy a separate Part D plan.
- No Extra Benefits: Unlike Medicare Advantage, Medigap plans generally do not cover routine dental, vision, or hearing care.
Who is Medicare Supplement Best For?
These plans are often a great fit for individuals who:
- Want the freedom to see any doctor or specialist in the United States who accepts Medicare.
- Do not want to deal with network restrictions, referrals, or pre-authorizations.
- Travel frequently across the country.
- Prefer to pay a higher monthly premium in exchange for near-zero out-of-pocket costs when they go to the hospital or doctor.
Medigap Open Enrollment
The best time to buy a Medigap policy is during your 6-month Medigap Open Enrollment Period. During this time, you can buy any Medigap policy sold in your state, even if you have health problems. If you apply after this window, insurance companies may use medical underwriting to decide whether to accept your application and how much to charge you.
Let Medicji Compare Medigap Options for You
Because Medigap benefits are standardized, the main difference between carriers is often the premium. Medicji compares rates and carriers available in your area after your consultation.