Medigap is Medicare Supplement Insurance that helps fill "gaps" in Original Medicare and is sold by private companies. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. You are responsible for approximately 20% of medical bills. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs.
|Note: Medigap plans sold to people who are newly eligible for Medicare aren’t allowed to cover the Part B deductible. Because of this, Plans C and F aren’t available to people newly eligible for Medicare on or after January 1, 2020. If you already have or were covered by Plan C or F (or the Plan F high deductible version) before January 1, 2020, you can keep your plan. If you were eligible for Medicare before January 1, 2020, but not yet enrolled, you may be able to buy one of these plans that cover the Part B deductible.|
Some Medigap policies also cover services that Original Medicare doesn't cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, here's what happens:
- Medicare will pay its share of the for covered health care costs.
- Then, your Medigap policy pays its share.
8 things to know about Medigap/Supplement policies
- You must have Medicare Part A and Part B.
- A Medigap or Supplement policy is different from a Medicare Advantage Plan. The Supplement fills in the 20% that Medicare doesn't pay.
- You pay the private insurance company a monthly for your Medigap/Supplement or your Advantage plan policy. You pay this monthly premium in addition to the monthly Part B premium that you pay to Medicare. Once you turn on your Part B premium, you will continue to pay this premium.
- A Medigap/Supplement policy only covers one person. If you and your spouse both want Medigap/Supplement coverage, you'll each have to buy separate policies.
- You can buy a Medigap/Supplement policy from any insurance company that's licensed in your state to sell one.
- Any standardized Medigap/Supplement policy is guaranteed renewable even if you have health problems. This means the insurance company can't cancel your Medigap policy as long as you pay the premium.
- Some Medigap/Supplement policies sold in the past cover prescription drugs. But, Medigap policies sold after January 1, 2006 aren't allowed to include prescription drug coverage. If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D). If you buy Medigap and a Medicare drug plan from the same company, you may need to make 2 separate premium payments. Contact the company to find out how to pay your premiums.
- It's illegal for anyone to sell you a Medigap/Supplement policy if you have a Medicare Advantage Plan, unless you're switching back to Original Medicare.
Medigap policies don't cover everything
Medigap policies generally don't cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.