What is a Medicare Supplement Plan?

A Medicare Supplement plan, also referred to as Medigap, is a health insurance policy sold by private insurance companies to fill the gaps in Medicare Parts A and B.  

Why Enroll a Medicare Supplement?

Many Medicare beneficiaries don’t realize that Original Medicare doesn’t pay for all of your medical expenses. While Original Medicare does provide comprehensive health coverage, you are still responsible for copays, coinsurance and deductibles. 

It is often overlooked that there is no out-of-pocket spending limit for Medicare covered services when using Original Medicare benefits without a Medicare Supplement plan. 

For example, after your Part B deductible, you are responsible for 20% of covered services. This 20% coinsurance has no limit. This means you are exposed to unlimited claims cost-sharing. 

Enrolling in a Medicare Supplement will help cover the 20% of Part B, as well as expenses associated with Part A. 

A Closer Look at Medicare Supplement

When To Enroll in a Medicare Supplement Plan

The ideal time to enroll in a Medicare Supplement plan is during your Medicare Supplement Open Enrollment period. This enrollment period begins the first day of the first month in which you’re 65 or older and enrolled in Medicare Part B. 

The importance of this enrollment period is that you can secure a Medicare Supplement policy without any medical underwriting.  This means that the insurance company can’t deny you coverage or rate up your premium due to pre-existing health conditions.  if you have pre-existing conditions, you will not be penalized, rated or denied coverage during this enrollment period.  

Should you miss this enrollment period, applying for a new policy will subject you to medical underwriting. 

You can not have a Medigap policy as well as a Medicare Advantage plan at the same time.

Some Tips About Medigap Policies

Medigap policies are pretty straight-forward, but there are a number of specific rules that apply when enrolling in this type of coverage.  Here are some tips that are helpful to know about Medigap policies, but call us at 703-214-4600 if you’d like more information.

  •  In order to purchase a Medigap policy, you must have Medicare Part A and Part B.
  • If you are currently enrolled in a Medicare Advantage Plan, you can apply for a Medigap policy, but make sure you can disenroll from the Medicare Advantage Plan before your Medigap policy begins.
  • Your monthly premiums for a Medigap policy are paid to a private insurance company and are in addition to the monthly Part B premium that you pay to Medicare.
  • A Medigap policy is issued to a single beneficiary. If you and your spouse both want a Medigap policy, you will each have to purchase separate policies.
  • You can buy a Medigap policy from any insurance company that is licensed in your state to sell one.
  • Any standardized Medigap policy is guaranteed renewable even if you have health problems. Guaranteed renewable simply means that the insurance company cannot cancel your Medigap policy as long as you pay the premium.
  • Some Medigap policies sold in the past combined medical and prescription drugs benefits. All Medigap policies sold after January 1, 2006, aren’t allowed to include prescription drug coverage. If you want prescription drug coverage, you should consider joining a Part D plan.
  • If you have a Medicare Medical Savings Account (MSA) Plan, it is illegal for anyone to sell you a Medigap policy.

Need Additional Coverage?

Want to explore your Medicare Supplement options?  Contact us and we can assist you in finding the right plan. 

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