Supplementing Your Medicare Coverage with Medigap Policies

As you approach your retirement years, healthcare coverage becomes a crucial factor to consider. Medicare is a federal health insurance program that provides coverage to those aged 65 and older, as well as those with certain disabilities. While Medicare provides significant coverage, it does not cover everything, and there may be gaps in coverage that can lead to significant out-of-pocket costs. This is where Medigap policies come in, to help fill those gaps and provide additional coverage for healthcare expenses. In this article, we’ll take a closer look at Medigap policies, how they work, and what you need to know about them.

What is a Medigap policy?

Medigap policies, also known as Medicare Supplement plans, are private insurance policies designed to supplement the coverage provided by Original Medicare (Part A and Part B). These policies are sold by private insurance companies and are standardized across most states. They can help pay for certain healthcare costs that Medicare does not cover, such as copayments, coinsurance, and deductibles.

Who is eligible for a Medigap policy?

To be eligible for a Medigap policy, you must be enrolled in Medicare Part A and Part B. You cannot have both a Medigap policy and a Medicare Advantage plan at the same time. If you have a Medicare Advantage plan, you may be able to switch to a Medigap policy during certain enrollment periods.

When can you enroll in a Medigap policy?

The best time to enroll in a Medigap policy is during your Medigap Open Enrollment Period. This period starts on the first day of the month in which you are 65 or older and enrolled in Medicare Part B. During this time, you have a guaranteed right to buy any Medigap policy sold in your state, regardless of your health status. Insurance companies cannot deny you coverage or charge you more for a policy based on pre-existing conditions.

If you miss your Medigap Open Enrollment Period, you may still be able to enroll in a Medigap policy, but insurance companies may be able to charge you more or deny you coverage based on your health status.

What do Medigap policies cover?

Medigap policies are standardized across most states and are labeled with letters (A, B, C, D, F, G, K, L, M, and N). Each lettered plan offers a different set of benefits, and all plans with the same letter offer the same benefits. For example, Medigap Plan F is the most comprehensive plan and covers all Medicare deductibles, coinsurance, and copayments.

Some of the most common benefits covered by Medigap policies include:

Medicare Part A coinsurance and hospital costs

Medicare Part B coinsurance or copayment

Blood (first three pints)

Part A hospice care coinsurance or copayment

Skilled nursing facility care coinsurance

Part A deductible

Part B deductible

Part B excess charges

Foreign travel emergency (up to plan limits)

It’s important to note that Medigap policies do not cover prescription drugs. If you need prescription drug coverage, you will need to enroll in a separate Medicare Part D plan.