In Original Medicare, you generally pay some of the costs for approved services. Medicare Supplement Insurance (Medigap) is extra insurance you can buy from a private company that helps pay your share of costs.
Despite the existing gaps in coverage, certain individuals are left with significant out-of-pocket costs. Medicare Supplement Plans were created to bridge these gaps, which is why they are commonly referred to as "Medigap" plans.
A Medicare Supplement plan, when combined with Original Medicare, is widely accepted nationwide by any provider that accepts Medicare patients. This combination typically offers the lowest out-of-pocket costs and the highest level of flexibility. Keep in mind that costs are influenced by factors such as age, gender, location, tobacco use, and household eligibility for discounts. Premiums can vary significantly depending on your individual circumstances and the insurance provider you choose.
What is a Medicare Supplement plan?
Medicare Supplement Plans cover expenses that are typically the responsibility of the patient that Medicare doesn’t pay. These expenses may encompass deductibles, co-pays, and coinsurance.
Medicare covers its standard expenses initially, followed by a Medicare Supplement plan that handles its portion. Typically, the Medicare Supplement plan covers the outstanding bill, although this may differ based on the plan’s structure.
The Ten Types of Medicare Supplement (Medigap) Plans
In 1990, Medicare standardized all Medicare Supplement plans by assigning each a letter designation. Beneficiaries have the option to enroll in Medigap plans A, B, C, D, F, G, K, L, M, or N. Regardless of the insurance provider, plans with the same letter provide identical benefits. Those eligible for Medicare after January 1, 2020 cannot buy a Medicare Supplement plan C or plan F. The key distinguishing factor among Medicare Supplement plans, or Medigap, is the premium cost. It is advisable for beneficiaries to compare and contrast plans to select one that aligns with their requirements and financial constraints.
Some items are generally not covered by any Medicare Supplement plan:
- Routine dental, hearing, and vision exams
- Glasses or contacts
- Hearing aids
- Retail prescription drugs
- Long-term care or custodial care
Enrolling in a Medicare Supplement plan
When your open enrollment period occurs, here’s what you need to know:
- Medicare Supplement Open Enrollment happens one time for most individuals
- Open Enrollment does not occur yearly; once you miss the chance, it's over.
- Medicare Supplement Open Enrollment lasts for six months
- You might be subject to health questions if you apply outside of your open enrollment period or do not qualify for another guaranteed issue period.
- It is not required for insurance companies to issue you a Medicare supplement plan except during your open enrollment period or in certain guaranteed issue situations.
Medicare Supplement Open Enrollment begins on the first month that you have Medicare Part B and are age 65 or older. The window for enrollment in a Medicare Supplement plan lasts for six months, and then closes. Some states have additional open enrollment periods, including those for people under age 65.
For additional information, please visit Medicare.gov.
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