What About Medigap? (Medicare Supplement Insurance)
If you decide to stick with Original Medicare (Parts A and B), you are still left with potential out-of-pocket costs like deductibles and the 20% coinsurance. To help cover these gaps, you can buy a Medicare Supplement Insurance policy, also known as Medigap.
Medigap policies are sold by private insurance companies. Their job is simple: to pay for some or all of the costs that Original Medicare does not cover. For example, a Medigap policy might pay your Part B coinsurance, so instead of you being responsible for 20% of a doctor’s bill, your Medigap policy pays it for you.
How Medigap Works
It is important to understand that Medigap works *with* Original Medicare. It does not replace it. You will present both your red, white, and blue Medicare card and your Medigap policy card when you receive medical care. Medicare will pay its share first, and then your Medigap policy will pay its share.
Medigap plans are standardized. In most states, they are identified by letters (Plan A, B, C, D, F, G, K, L, M, N). Each plan with the same letter must offer the same basic benefits, regardless of which insurance company sells it. This makes it easier to compare plans. The only difference between a Plan G from one company and a Plan G from another will be the price (the premium) and the company’s customer service.
It is crucial to know that Medigap policies do not cover prescription drugs. If you choose Original Medicare and a Medigap plan, you will still need to purchase a separate Part D plan for your medications.
When to Buy a Medigap Policy
The best time to buy a Medigap policy is during your 6-month Medigap Open Enrollment Period. This period starts on the first day of the month in which you are both 65 or older and enrolled in Medicare Part B. During this window, an insurance company cannot refuse to sell you any Medigap policy it offers, regardless of your health status. They also cannot charge you more because of pre-existing health conditions.
If you miss this window and try to buy a policy later, you may have to go through medical underwriting, and companies could deny you coverage or charge you a higher premium based on your health. This makes the Medigap Open Enrollment Period one of the most important deadlines to watch when you are new to Medicare.
