Medigap Supplemental Insurance Explained


Medigap is a supplemental health insurance policy sold by private insurance companies to fill gaps in Medicare coverage.

What Is Medigap?

Medigap, also known as Medicare Supplemental Insurance, is a supplemental health insurance policy sold by private insurance companies to fill gaps in Original Medicare Plan coverage. Medigap helps to pay for health care costs such as co-insurance, co-payments, and deductibles.

What Are Medigap Policies and What Do They Cover?

Medigap has 12 different policies: Medigap Plans A through L. If you or a loved one is considering Medigap supplemental coverage, review each Medigap plan carefully. Each plan has a different basic and extra benefits, and different costs.

Depending on the policy, Medigap plans cover the following expenses:

  • Stays in a skilled nursing facility
  • Blood (first 3 pints annually)
  • Medicare Part A coinsurance and hospital benefits
  • Medicare Part B annual deductible
  • Medicare Part B co-payments
  • Excess doctor charges
  • Foreign travel emergencies
  • Routine checkups
  • At-home recovery

If you are married, you and your spouse must purchase separate policies. All of these policies are regulated by the federal and state governments.

How Does Medigap Work with Medicare and Medicaid?

If you buy a Medigap policy, you must have Medicare Part A and Medicare Part B. You will pay the monthly premium for Medicare. Medigap coverage is renewed annually and also requires a monthly premium.

Residents of Massachusetts, Minnesota, and Wisconsin have specialized plans. Plans K and L only provide benefits that supplement those covered under Medicare Parts A and B. Plans K and L also require a predetermined out-of-pocket expenditure before paying the full supplemental benefit for the remainder of the calendar year.

If you wish to buy a Medigap Policy, you cannot be a Medicaid recipient.

How Does Medigap Work with Insurance Companies?

Insurance companies provide Medigap policies, and decide which Medigap plans they want to offer. Though each plan remains the same regardless of the company providing it, the cost of the policy is up to the insurance company. The same Medigap plan can have a different cost depending on the company offering the policy.

Carefully consider which policy is right for you and be sure to shop for the best rates.

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