Medicare Supplement

What is the meaning of Medicare Supplement, or Medigap?

Medicare Supplement Insurance, commonly referred to as Medigap, is a form of private health insurance that provides additional coverage to complement Original Medicare (Part A and Part B). It assists in covering the approximately 20% of healthcare expenses that Original Medicare does not fully cover.


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What's Medicare Supplement Insurance (Medigap)?

Medigap, also referred to as Medicare Supplement Insurance, is provided by private companies to help fill the "gaps" in coverage that exist with Original Medicare. While Original Medicare covers a substantial portion of healthcare expenses, it does not cover all costs for covered services and supplies. Medigap policies are designed to assist in paying for some of the remaining healthcare expenses, including copayments, coinsurance, and deductibles.

What is covered by Medicare Supplement Insurance?

Medicare Supplement Insurance, also known as Medigap, assists in covering expenses that Original Medicare Part A and Part B do not fully pay for. These plans help with copayments, coinsurance, and deductibles associated with Part A (hospital care) and Part B (medical care), as well as additional out-of-pocket costs related to hospitalization, doctor's services, home health care, laboratory expenses, durable medical equipment, and more.

After Medicare pays its share of the Medicare-approved amount for covered healthcare costs, your Medicare Supplement Insurance plan will then cover its portion of the costs it includes.

There is a wide range of Medicare Supplement plans available, varying in coverage and costs, ranging from basic plans to more comprehensive options.

What is not covered by Medicare Supplement Insurance?

Medicare Supplement policies do not provide coverage for prescription drugs or dental services. However, it is possible to purchase separate plans specifically designed to cover these needs. Cigna, for instance, offers prescription drug and dental plans with affordable monthly premiums.

How does Medicare Supplement Insurance interact with Medicare?

Medicare Supplement Insurance complements Original Medicare Parts A and B. It also works in conjunction with standalone Part D Prescription Drug plans if you decide to purchase one.

It is essential to understand that Medicare Supplement Insurance is separate from Medicare Advantage. You can enroll in either a Medicare Advantage Plan or a Medicare Supplement Plan, but you cannot have both simultaneously.

Who qualifies for Medicare Supplement Insurance?

Individuals who are 65 years of age or older and enrolled in Medicare Part B are generally eligible to apply for Medicare Supplement Insurance. The ideal time to enroll is during the 6-month open enrollment period, which begins on the first day of the month in which you turn 65 and are enrolled in Part B. During this period, you have the right to purchase any Medicare Supplement plan available in your state, and you are guaranteed coverage regardless of any pre-existing health conditions.

For individuals who are under 65 and have Medicare eligibility due to a disability, the availability of Medicare Supplement plans may vary depending on the state. It's recommended to check with your state's regulations to determine eligibility and options for Medicare Supplement Insurance.

What are the available types of Medicare Supplement Plans?

Medicare Supplement plans come in a variety of options, each identified by a letter from A to N (distinct from the alphabetical naming of other parts of Medicare).

These plans span a spectrum, from basic coverage to more comprehensive coverage. Assessing your healthcare requirements and financial circumstances can assist you in selecting the most suitable Medicare Supplement plan for your needs.

Insurance plans that differ from Medigap

Insurance plans that are not classified as Medigap include:

  • Medicare Advantage Plans, such as Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), or Private Fee-for-Service (PFFS) Plans.
  • Medicare Prescription Drug Plans.
  • Medicaid.
  • Employer or union plans, including the Federal Employees Health Benefits Program (FEHBP).
  • Tricare.
  • Veterans' benefits.
  • Long-term care insurance policies.
  • Indian Health Service, Tribal, and Urban Indian Health plans.

Medigap policies do not provide coverage for all healthcare expenses

Medigap policies typically do not cover the following:

  • Long-term care, including non-skilled care received in a nursing home.
  • Vision or dental services.
  • Hearing aids.
  • Eyeglasses.
  • Private-duty nursing.

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