Medicare supplement (Medigap)

Medigap is a private health insurance policy that works alongside Original Medicare. It helps pay for certain healthcare costs not covered by Medicare, ensuring that your out-of-pocket expenses are kept to a minimum. By covering these gaps, Medigap makes it easier for you to predict your healthcare costs and avoid large, unexpected medical bills.

• Complementary Coverage: Medigap works in conjunction with Original Medicare, meaning Medicare pays its share of the Medicare-approved amount for covered healthcare costs first, and then your Medigap policy pays its share.
• Standardized Plans: Medigap policies are standardized across the country, which means the benefits for each plan type (labeled Plan A, Plan B, Plan C, etc.) are identical regardless of the insurance provider. This makes it easier to compare options and know exactly what each plan offers.

• Coverage for Out-of-Pocket Costs: Medigap policies help cover deductibles, copayments, and coinsurance that Original Medicare doesn’t fully pay for.
• Freedom to Choose Providers: With Medigap, you can see any doctor or visit any hospital nationwide that accepts Medicare patients, giving you flexibility in your healthcare choices.
• Guaranteed Renewal: Medigap policies are guaranteed renewable as long as you pay your premiums on time. This means you can keep your coverage even if your health condition changes.
• Emergency Foreign Travel Coverage: Some Medigap policies offer emergency healthcare coverage while traveling outside the United States, providing extra peace of mind when you’re abroad.

While Medigap provides valuable additional coverage, it doesn’t cover everything. Here are some examples of what Medigap policies typically do not cover:

• Prescription Drugs: You will need a separate Medicare Part D plan to cover prescription drugs.
• Long-term Care: Custodial care in a nursing home or assisted living facility is not covered.
• Vision and Dental: Routine dental, vision, and hearing services are not covered by Medigap.

Medigap plans are labeled from Plan A to Plan N, and each one offers a different set of benefits. These plans are standardized, meaning that each plan with the same letter must offer the same coverage, regardless of the insurance company. Some common plan options include:

• Medigap Plan A: Offers basic benefits, covering Medicare Part A and Part B coinsurance, as well as hospice care coinsurance.
• Medigap Plan F: Provides comprehensive coverage, including the Medicare Part A and Part B deductibles, with very few out-of-pocket costs. Plan F is not available to those who became eligible for Medicare after January 1, 2020.
• Medigap Plan G: Similar to Plan F, but does not cover the Medicare Part B deductible. It is popular among new enrollees for its robust coverage options.
• Medigap Plan N: Covers Part A deductibles and coinsurance, but with some copayments for doctor visits and emergency room trips.

To purchase a Medigap policy, you must be enrolled in Medicare Part A and Part B. Additionally, Medigap is only available to those with Original Medicare, not for those enrolled in a Medicare Advantage plan.

The best time to buy a Medigap policy is during your Medigap Open Enrollment Period, which is a 6-month period that starts the month you are both 65 or older and enrolled in Part B. During this period, you can buy any Medigap policy sold in your state without underwriting or being denied coverage based on health status.

Choosing the right Medigap plan depends on your healthcare needs and budget. Consider the following when choosing a plan:

• Current and Future Healthcare Needs: Look at your health history, family health trends, and current conditions to determine the type of coverage you may need.
• Budget: Different plans have different monthly premium costs, which can depend on factors such as location, age, and the insurer.
• Coverage Needs: If you anticipate frequent doctor visits or hospital stays, a more comprehensive plan like Plan G may provide the best financial protection.

Our team at The Medicare Firm can help you evaluate your needs, understand your options, and guide you in selecting the right Medigap plan that best suits your situation.

Medigap premiums vary based on several factors:

• Age: Some policies are age-rated, meaning your premium may increase as you get older.
• Location: Premiums can vary depending on where you live.
• Health Underwriting: If you enroll outside of your open enrollment period, you may be subject to health underwriting, which could affect your premium or eligibility for coverage.

It’s important to compare costs between insurers, as Medigap policies with the same coverage can vary significantly in price. However, all plans with the same letter must offer identical benefits.

Medigap is different from a Medicare Advantage (Part C) plan. While Medigap supplements your Original Medicare coverage to reduce out-of-pocket costs, Medicare Advantage is an alternative way to receive your Medicare benefits through private insurance. Medicare Advantage plans often include additional services, like vision, dental, and prescription drug coverage, but they may have limited networks of providers.

To enroll in a Medigap plan:

1. Understand Your Coverage Needs: Determine which gaps in Medicare coverage you need to address.
2. Compare Plans: Look at standardized Medigap plans to see which one best fits your needs.
3. Contact an Insurance Provider: Medigap policies are offered by private insurance companies. Contact an authorized agent, like The Medicare Firm, to get quotes and information on enrolling.
4. Enroll During Open Enrollment: The best time to enroll is during your 6-month Medigap Open Enrollment Period, starting when you are 65 or older and have Part B.

We’re Here to Help

At The Medicare Firm, we’re committed to providing guidance and support as you navigate your Medicare options. Whether you need help comparing plans, understanding eligibility, or finding the most affordable coverage, we are here to assist you.

Reach out to us to get personalized assistance with Medigap policies and ensure you have the right coverage to fill the gaps in your Medicare plan.