What is a Medicare Supplement Insurance Plan?

A Medicare Supplement (also known as “Medigap” or “Med Supp”) is a policy sold by private insurance companies that fills the “gaps” in Medicare Parts A and B coverage. This type of policy can help pay your share of coinsurance, copayments, deductibles or premiums of Medicare-covered services. There are twelve standardized Plans offered in every state except for Massachusetts, Minnesota, and Wisconsin which have their own plans. This means that a Plan F policy provisions will be the same in every state – the only difference between companies is pricing. Med Supp policies only work with Medicare Parts A and B. They do not cover your cost share associated with any other types of health coverage.

For instance, Medicare Advantage Prescription Drug (MAPD), stand-alone Prescription Drug Plans (PDP), Employer/Union group health coverage, Medicaid, Veterans Administration Benefits, or TRICARE are all separate plans for which a Med Supp will not cover all of the non-reimbursed costs. You don’t need both a Med Supp and a MAPD plan at the same time and in most cases you cannot have a Med Supp and Medicaid at the same time. It is important to note that a Med Supp plan will not pay claims if you are enrolled in a MAPD plan and in most cases you do not need a Med Supp if you have Medicaid.

What are the Things You Should Know about Medigap Policies?

  • You must have Medicare Part A and Part B to purchase a Medigap product.
  • You must continue to pay your Part B premium just like with a Medicare Advantage plan.
  • If you have a Medicare Advantage Plan, you can apply for a Medigap policy but you MUST make sure that you terminate Medicare Advantage Plan before your Medigap policy begins.
  • A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you’ll each need to purchase separate policies.
  • You can buy a Medigap policy from any insurance company that is licensed in your state to market these products.
  • Any standardized Medigap policy is guaranteed renewable even if you have health issues. This means the insurance company cannot cancel your Medigap policy as long as you pay the premium and a policy is not misrepresented.
  • Some Medigap policies sold in the past cover prescription drugs but Medigap policies sold after January 1, 2006 are not allowed to include prescription drug coverage. If you want prescription drug coverage, you can purchase a Medicare Prescription Drug Plan (Part D).
  • It is illegal for anyone to sell you a Medigap policy if you have a Medicare Medical Savings Account (MSA) Plan.
  • Medigap policies do not cover long term care, vision, dental, hearing aids, eyeglasses or private-duty nursing. However, there are carriers that offer innovative benefits in which these services may be covered.
  • Starting January 1, 2020 Medigap Plans F and C that offer the Part B deductible will not be allowed to be sold to people new to Medicare. If you already have either of these two plans (or the high deductible version of Plan F) or are covered by one of these plans prior to January 1, 2020, you will be able to keep your plan. If you were eligible for Medicare before January 1, 2020 but not yet enrolled, you may be able to buy one of these plans.


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