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Medicare 101: What You Need to Know About Medicare Supplement Plans

What You Need to Know About Medicare Supplement Plans

Even though you have coverage with Original Medicare, know that there are some health care costs that Original Medicare doesn’t cover. The history of Medicare Supplement Insurance dates to the 1980’s when the government created a voluntary program to allow Medicare beneficiaries to get coverage for gaps in Medicare.

Medigap is additional Medicare coverage sold by private insurance companies to help pay for some costs not covered by Original Medicare.

Most states have ten standardized Medicare Supplement Plans to choose from (excluding Massachusetts, Minnesota, and Wisconsin who have their own standardized plans). Each plan is identified with a letter from A-N.

Medicare Supplement plans cover out-of-pockets costs such as Medicare deductibles, coinsurance, hospital costs after Medicare-covered days, skilled nursing facility costs after Medicare-covered days.

Long-term, vision, dental, hearing and private duty care are not covered under a Medicare Supplement.

Key Points You Must Know About a Medigap Plan

  1. You must have Medicare Part A and Part B (You cannot purchase a Medigap Plan if you have Medicare Advantage)
  2. If you have a Medicare Advantage Plan, you can apply for a Medicare Supplement but must leave your Advantage Plan before Medigap coverage begins.
  3. Private insurance companies sell Medicare Supplements Plans and each plan require a monthly premium. You can purchase a plan from any insurance company licensed in your state.
  4. A Medigap Plan only covers one person. For married couples, each person must have their own Medigap policy.
  5. Any standard Medigap policy is guaranteed renewable regardless of health problems. Insurance companies cannot cancel your policy if your pay your premium.
  6. If you have a Medicare Medical Savings Accounts (MSA) Plan, it is illegal for someone to sell you a Medigap policy

When Should I Enroll in a Medigap Policy?

The best time to enroll in a Medigap Policy is during your Medigap Open Enrollment Period. This six-month period begins the first day of the month you are 65 or older and enrolled in Medicare Part B. During this period, you have guaranteed issue right to enroll in any Medigap plan regardless of any health problems. If you miss your enrollment period, you may be subject underwriting and could be denied coverage for any pre-existing conditions.

Cost of a Medicare Supplement

Insurance companies have three ways to price our Medigap plans

  1. Community-related – premiums are not rated based on your age
  2. Issue-age related – the age when you purchase the policy will dictate the monthly premium
  3. Attained-age related – premiums will increase with age

Why Should I Buy?

  • No networks to worry about
  • Use any Medicare Doctor
  • No referrals necessary
  • Travel from state to state with it
  • Budget friendly premiums
  • Eliminates the guesswork for hospital/doctor bills
  • Peace of mind knowing you’re fully covered

To view a comparison of each Medigap Plan and its coverage, please visit our Compare Medicare Supplement page. Sometimes the least expensive plan does not offer all the “gap” coverage so it is important to compare plans and their benefits before making a purchase.

We can help you save time and money. For help finding the best Medicare Supplement Plan for you, please call us at (800) 750-2407.