5 Things to Know about Medigap

Most people are aware of Original Medicare (Part A and Part B), but there can be some confusion when it comes to supplemental and alternative plans. 

Do you have a chronic illness or recurring doctor visits? Are you worried about how you’ll pay for your Medicare copays, deductibles, and premiums? Medigap can help with that.

Medigap, or Medicare Supplement, exists to help you fill in the gaps in your Medicare coverage by paying for things like copays and deductibles. In order to qualify for Medigap, you must have Original Medicare (Part A and Part B). Medigap is sold by private insurance companies and offers 10 standard plans, with the exception of Massachusetts, Minnesota, and Wisconsin which have their own standard plans.

Here are five things you need to know about Medigap:

1. A Medigap plan only covers one person.

Medicare beneficiaries can’t add a spouse to their Medigap plan. Medigap offers 10 standard plans (A-N), so it’s wise to choose a plan that works best for you and your healthcare needs.

2. You must have Medicare Part A and Part B to enroll.

Once you have Medicare Part B, you enter the Medigap Open Enrollment Period. This is a six-month window in which you can purchase a Medigap plan for the same price as a healthy person. Outside of this window, there is no guarantee of coverage, and if you do receive coverage, you could be charged a higher premium.

3. You can’t have a Medicare Advantage plan and a Medigap plan at the same time.

It is illegal for an insurance broker to sell you a Medigap policy if you have Medicare Advantage. If you switch from Original Medicare with Medigap to a Medicare Advantage plan, you will need to drop your Medigap plan.

4. You will have to pay a premium for Medigap on top of your Part B premium.

You cannot use a Medigap plan to pay your Medicare Part B premium, and Medigap carries a separate premium you will have to pay in addition to your Part B premium.

5. Shop around Medigap plans before signing up.

Medigap coverage is standard across the country. For example, Plan N in Tennessee gets the same coverage as Plan N in Washington. However, prices may vary depending on where you live and which private insurance company provides your coverage.

The most popular Medigap plan, Plan F, is being phased out in 2020. If you are enrolled in this plan before then, you’ll be grandfathered in. Plan F also has the highest premium, so shop around before committing to a plan.