You’re almost 65 and about to transition to senior health insurance. One of your options is Medicare Supplement Insurance, also known as Medigap. Here are a few things that you should know about Medigap policies before you sign up. (For a full step-by-step rundown of what to do this year, see our Turning 65 Medicare enrollment checklist.)
1) You Need Both Medicare Part A & B
Before you can enroll in a Medigap plan you must enroll in Medicare Part A and B. The reason is Medigap fills in the gaps that Original Medicare leaves open, therefore you would need both. You are still responsible for your Part B premium (most people do not pay a Medicare Part A premium).
2) Medigap is not Medicare Part C
Medigap is supplemental insurance, while Medicare Part C, known as Medicare Advantage, replaces Original Medicare. MA plans generally offer additional benefits such as Rx coverage, dental, and vision. Medigap works differently: for instance, with Plan G, the most comprehensive Medigap plan available to those new to Medicare, your plan pays the coinsurance and excess charges for things like hospitalization, skilled nursing, and hospice care, and extends your hospitalization coverage by 365 days. Plan F once offered similar first-dollar coverage, but it is no longer sold to anyone who became eligible for Medicare on or after January 1, 2020, so Plan G is the plan to focus on today.
3) Enroll in Medigap During your Initial Open Enrollment
Medigap plans, unlike Medicare Advantage plans, can turn you down if you apply after your initial open enrollment period if you have preexisting conditions. There are exceptions 1) a special Medigap enrollment period for those who qualify for guaranteed enrollment under certain circumstances, such as when your retirement health plan ends. 2) Some states like New York and Conn allow you to enroll in Medigap year round. Check out our guide to Medicare enrollment periods breaks them all down. To be on the safe side, enroll in Medigap as soon as you become eligible for Medicare Part B, if that is the route you choose to go.
Missed your initial enrollment period? You still have a chance to sign up for Medigap, but you’ll likely need to answer some health questions, and insurers might deny your application. If this describes your situation, our Instant Medigap Underwriting Checker can provide insight into whether you’ll be approved for medical underwriting, saving you time and worry. Contact Senior65.com for complimentary help at 800-930-7956 or leave a comment below.
4) You’ll Need a Separate Rx Plan with Medigap
Even though Medigap offers a lot of extended coverage, this does not carry over to prescription coverage. Medicare Part D, otherwise known as a Prescription Drug Plan, is separate from Original Medicare and therefore separate from Medigap. Recent rules also added an annual out-of-pocket cap ($2,100) on what you pay for covered drugs, so a Part D plan now protects you from runaway prescription costs. Remember to choose a plan that covers all or the majority of the prescriptions you take now, and see our step-by-step guide to enrolling in Part D for help.
To learn more about Medigap call 800-930-7956 or contact Senior65.com.