If you are getting ready to enroll in Medicare, you may have heard about Medigap plans and are wondering what they are. So what are Medigap plans and how do they work? Medigap is supplemental insurance for Original Medicare. At age 65, beneficiaries usually choose to go with Original Medicare, Medicare plus Medigap, or a Medicare Advantage plan.
Medigap Covers the Gaps
As its name suggests, Medigap covers the “gaps” in insurance that Original Medicare does not cover, such as copayments, coinsurance, and deductibles, and is handled through a private insurance company. You can purchase a Medigap plan by choosing from plans available in your state that fit your needs.
You will pay a monthly premium for your Medigap policy, in addition to the monthly premium you pay for Part B. You are eligible for a Medigap plan if you have Medicare Parts A and B already. Take note, however, that you can’t have Medigap plan and a Medicare Advantage plan at the same time.
The rules for Medigap’s offerings and benefits vary by insurance company and by state, however there are some similarities across Medigap Plans A through N that you can compare here. A Medigap plan may make you wait up to 6 months for coverage if you have a pre-existing condition.
Your Medigap policy covers only you, and not your spouse. Also note that if you have a Medicare Savings Account (MSA) Plan, it’s illegal for anyone to sell you a Medigap policy.
Any Medigap plan is guaranteed renewable as long as you pay your premiums. There are also guaranteed issue rights associated with your Medigap policy, which give you a right to purchase a Medigap plan in certain scenarios.
When and How to Enroll
Open enrollment for a Medigap plans is six months from the first day of the month of your 65th birthday if you are signed up for Medicare part B, or 6 months from the date you sign up for Part B.
You can purchase a Medigap policy from any insurance company in your state that is licensed to sell one. Do some research to see which ones fits your needs. Visit Medicare’s Medigap Policy Search to find a Medigap plan in your area. And consult these questions to ask when choosing a Medigap policy.
Congressional Bill Will Eliminate Plans F and C
Unfortunately for Medigap consumers, in order to save Medicare money Congress passed a bill on April 14, 2015, which will eliminate Medigap Plans F and C, which cover the part B deductible for new Medicare beneficiaries, starting January 1, 2020. Learn more here.
Related Links
Know Your Guaranteed Issue Rights for Medigap
VIDEO: Medicare Advantage vs Medigap
Navigating the Medigap Highway
