Medigap, aka Medicare Supplemental insurance, is designed to protect seniors from costly medical expenses left by Original Medicare. We know it can seem a little complicated, so here is a list of 5 things you should know before applying for a Medigap policy.
1) Medigap: What it Covers
Medigap fills in the gaps that Original Medicare leaves behind. Every Medigap plan adds an extra 365 days of hospital coverage and pays all or part of your Part B coinsurance and your Part A hospital and hospice coinsurance. More comprehensive plans go further, covering things like the Part A deductible, Part B excess charges, foreign travel emergency care, and sometimes extras such as gym memberships. For most people new to Medicare, Plan G is the most comprehensive option available today.
2) Medicare Supplemental: What it Doesn’t Cover
Medigap doesn’t cover long-term care (LTC), and it does not work alongside a Medicare Advantage plan — you have Medigap or Medicare Advantage, not both. Medigap plans also do not include prescription drug coverage, so you buy a separate Medicare Part D plan for that, which now comes with an annual out-of-pocket cap of $2,100. Medigap also won’t pay for routine dental, vision, or hearing.
3) Sign Up for Medigap When 1st Eligible
Medigap, unlike Medicare Advantage, does not have an open enrollment period each year. Instead you get a one-time initial open enrollment period with guaranteed issuance regardless of preexisting conditions. This six-month window begins the month you turn 65 and are enrolled in Part B.
See our Medigap Special Enrollment guidelines, which explain when you can enroll outside your initial period without medical underwriting. Missed your window and don’t qualify for one of those? You can still apply through medical underwriting. Our Medigap Underwriting Checker is a quick way to see where you stand. Need help? Senior65.com is here for free at 800-930-7956, or leave a comment below.
4) Medigap Costs
With Medigap you will still pay your Part B premium ($202.90 for most people, though higher earners pay more), and most people pay nothing for Part A. On top of that you pay your Medigap monthly premium, and you buy a separate Part D drug plan. Medigap premiums depend on how comprehensive the plan is, where you live, and which company you buy from. They are generally higher than a Medicare Advantage plan’s premium, but your out-of-pocket costs are far more predictable. Because the same lettered plan is identical no matter who sells it, it pays to compare companies on price.
5) Medigap Requirements
You must have both Medicare Part A and Part B to enroll in a Medigap plan. This is because Medigap supplements Medicare; it does not replace it.
Get a Medigap Quote Enroll in Medigap
To learn more about Medigap, call our Senior65 team at 800-930-7956 or click here for your Medigap quote.