- You pay the private insurance company a monthly premium for your Medigap policy. This is in addition to the monthly Part B premium that you pay to Medicare.
- A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you’ll each have to buy separate policies.
- Medigap policies must be purchased from a licensed insurance company in your state.
- Any standardized Medigap 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 policies sold in the past cover prescription drugs. But, Medigap policies sold after January 1, 2006 aren’t allowed to include prescription drug coverage (this was the date the Medicare Modernization Act went into effect, establishing Medicare Prescription Drug Plan or Medicare Part D). Now, if you want additional prescription drug coverage, you’ll have to purchase Medicare Part D.
- Be aware it’s illegal for anyone to sell you a Medigap policy if you have a Medicare Advantage Plan, unless you’re switching back to Original Medicare.
WHO IS ELIGIBLE FOR MEDIGAP?
- To purchase a Medigap policy, you must have Medicare Part A, which helps pay for hospital services, and Medicare Part B, which covers the cost for doctor services.
- Those who have a Medicare Advantage plan cannot get a Medigap plan. Medicare Advantage Plans are ways to get Medicare benefits, while a Medigap policy serves as a supplement to your Original Medicare benefits.
WHAT HEALTHCARE COSTS DOES MEDIGAP COVER?
- Healthcare costs in foreign countries
WHAT HEALTHCARE COSTS DOES MEDIGAP NOT COVER?
- Long-term care
- Dental care
- Vision care
- Hearing Aids
- Private-duty nurses
- Most plans do not cover prescription drugs since Plan D does
CAN YOU HAVE BOTH ORIGINAL MEDICARE AND MEDIGAP?
Yes, you can. Medigap policies (or Medicare Supplement Insurance) are sold by private companies. If you have both, Medicare pays its share of the Medicare-approved amount for covered health care costs. Then, your Medigap policy pays its share.
INSURANCE PLANS THAT AREN’T MEDIGAP
- Medicare Advantage Plans (like an HMO, PPO, or Private Fee-for-Service Plan)
- Medicare Prescription Drug Plans
- Employer or union plans, including the Federal Employees Health Benefits Program (FEHBP)
- Veterans’ benefits
- Long-term care insurance policies
- Indian Health Service, Tribal, and Urban Indian Health plans
IS MEDIGAP FOR ME?
You can drop Medigap and switch to a Medicare Advantage Plan, especially if you want the additional prescription drug coverage Medicare Advantage Plans offer over Medigap. If you decide to drop your entire Medigap policy, you need to be careful about the timing as late enrollment penalties can be assessed. Our specialists at MedicareGov Directory can help you decide which option is best for you. We offer many Medicare Advantage Plans and can help you sort through the sometimes complicated regulations. Contact us today for more information!