If you find that your out-of-pocket expenses are too high with Original Medicare coverage, you may consider buying supplemental insurance to cover the gaps in your Medicare insurance. Medicare Supplement, also known as Medigap, policies, may help lower your out of pocket costs.
What is Medigap?
Medigap policies are supplemental health insurance policies that Original Medicare recipients can purchase from private insurance companies in the United States. Medigap policies help beneficiaries pay for out-of-pocket medical expenses they may have with their Original Medicare Parts A and Part B coverage, including deductibles, coinsurance, and copayments.
Please note: A Medigap policy is not the same thing as Medicare Advantage (Part C). Medicare Advantage is an alternative to Original Medicare. Medigap is an option for individuals with Original Medicare only. If you have a Medicare Advantage policy you cannot legally purchase a Medigap policy unless your return to Original Medicare Parts A and B.
Who is Eligible for Medigap Policies?
Anyone who has Original Medicare Part A and Part B can purchase a Medigap policy. When you turn 65 and have Part B, you will have a 6-month initial eligibility period during which you can purchase any Medigap plan sold in your state. According to U.S. federal laws, during this period of eligibility, no insurers can refuse to sell you a Medigap policy or set premiums based on past or current health conditions, or extend the waiting period beyond six months. After your 6-month period has ended, you will not have a guaranteed issue right for coverage and can be turned down or charged more based on medical underwriting.
Costs of a Medigap Policy
The Centers for Medicare & Medicaid Services (CMS) have established standards for all Medigap supplemental insurance policies. Standardized plans identified by letters are sold by private insurance companies throughout the country. You will pay a monthly premium for your plan that will depend on the coverage.
When you are considering which Medigap supplemental insurance plan to purchase, you shouldn’t base your final decision on monthly premiums alone. You should also take your medical expenses into consideration and figure out which policy offers the best benefits for you. Each Medigap policy covers only one person. So, if you want coverage for you and your spouse, you must have two separate policies.
Be sure to check out all the details of each of the Medigap plans available in your state so you can choose the best option for your medical needs and financial circumstances. These policies can be complicated so ask for assistance from a licensed health insurance agent if you have any questions.