What’s a Medicare Supplement Insurance (Medigap) Policy?

checkmark Fact checked Contributing expert: Leron Moore, Medicare consultant - Updated: Jan 12, 2022

 

A Medigap plan can cover expenses Medicare doesn’t. Learn about costs and coverage for Medicare Supplement Insurance Plans.

What you should know

  • 1 Medicare Supplement Insurance (Medigap) is available to help give you extended coverage outside of Original Medicare benefits.
  • 2 You must have both Medicare Parts A and B to be considered for a Medicare Supplement plan.
  • 3 Medicare Supplement plans are guaranteed renewal. As long as premiums are paid, the plan renews itself.
  • 4 Medicare Supplement policies don’t usually cover long-term care, vision, dental, hearing aids, or eyeglasses.

What Is Medicare Supplement Insurance (Medigap)?

Medicare Supplement Insurance or Medigap is secondary coverage that supports Original Medicare Parts A and B. Original Medicare pays its portion of the bill, then Medicare Supplement payments come in. 

Medicare Supplement Insurance:

  • Covers your 20% coinsurance in some cases
  • Allows for emergency benefits outside of the United States
  • Allows you to see any doctor that’s certified to see Medicare patients

You may be responsible for copays associated with Original Medicare if your Medigap plan doesn’t provide coverage for them. Medigap plans don’t provide coverage for the following:

  • Dental 
  • Vision and glasses 
  • Hearing aids 
  • Private nursing care 
  • Long-term care 
  • Prescription drug coverage 

How much does Medigap cost?

Medigap plan premiums range from about $26 to $470 per month. 

There are several factors that affect the cost of a Medicare Supplement plan. The plan premium is determined by:

  • The type of plan
  • Where you live
  • The carrier offering the plan

Can you have Medigap with a Medicare Advantage Plan?

While you can have both a Medigap plan and Medicare Advantage plan, it’s not beneficial to have both. If you decide to add a Medigap plan, it will be secondary to your Original Medicare plan. If you decide to enroll into a Medicare Advantage Plan, it will be your primary coverage and Original Medicare will be your secondary coverage.

Which is better, a Medigap policy or Medicare Advantage Plan?

Choosing between Medigap and a Medicare Advantage Plan depends on your needs and preferences. For example, if you need a plan with dental and prescription coverage, a Medicare Advantage Plan is your best option because Medigap doesn’t offer either coverage. But if you’re concerned about covering coinsurance or emergency coverage abroad, Medigap may be a better fit.

 

Benefits of Medicare Advantage Plans

  • Cost-effective coverage options 
  • Personalized plans 
  • Coordination of medical care 
  • Typically, an all-inclusive plan with both medical and prescription coverage
  • One insurance card can be used at all times 
  • Original Medicare deductibles aren’t applied 

Benefits of Medigap Policies

  • Flexible network of providers 
  • Typically covers most cost-share responsibilities 
  • In some cases, extra benefits offered
  • Nationwide coverage

When can you enroll in a Medigap plan?

Before enrolling in a Medigap plan, you must enroll in Medicare Parts A and B. Your Medigap Open Enrollment period starts when your Medicare Part B is effective. There’s a six-month window to enroll into a Medigap plan. 

Open Enrollment, by federal law, protects you with Guaranteed Issue Rights, meaning you can purchase a Medigap plan available regardless of your health. Any Medigap product purchased outside of that Open Enrollment window is subject to rejection. 

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Contributing Expert:

Leron Moore, Medicare consultant

Leron Moore has guided Medicare beneficiaries and their families as a Medicare professional for nearly 15 years. First as a Medicare provider enrollment specialist, and now a Medicare account executive, Moore works directly with Medicare beneficiaries to ensure they understand Medicare and Medicare Advantage Plans.