Medicare Supplement Plan (Medigap) Insurance Explained

Although Original Medicare covers many medical costs, it doesn’t pay for everything. A Medicare Supplement Insurance (Medigap) policy helps pay your remaining health care costs, such as deductibles, copayments, and coinsurance.

A Medicare Supplement is an extra health insurance plan that you purchase from a private insurance company. It covers health care costs that Original Medicare doesn’t pay. However, Medigap policies don’t include coverage for long-term care, dental, vision, hearing aids, eyeglasses, private-duty nursing, or prescription drugs.

To qualify for a Medigap policy, you must already have Medicare Part A and Part B. If you have a Medicare Advantage plan, you cannot purchase a Medigap policy.

When Should You Purchase a Medigap Policy?

The best time to buy a Medigap plan is during your open enrollment period. This period lasts for six months starting from the first day of the month you turn 65, as long as you’re also enrolled in Medicare Part B. It also applies if you sign up for Medicare Part B later.

For example, if you continue working past age 65 and keep your employer insurance until age 68 or 70, your open enrollment period begins once your employer coverage ends. During this window, you can buy any Medigap policy without medical underwriting (guaranteed issue).

If you wait until after the open enrollment period, insurers may require medical underwriting, raise your rates, or even deny you coverage.

How Much Does a Medigap Policy Cost?

Although Medigap benefits stay the same nationwide, the costs vary. You’ll pay:

• A monthly premium for your Medigap plan (in addition to your Medicare Part B premium)

• Rates that depend on your plan type, insurance company, location, and age

As long as you pay your premiums on time, the insurance company must renew your Medigap policy—even if you develop health problems later.

Medicare Supplement Plans vs. Medicare Advantage Plans

Insurance companies must follow federal rules to standardize Medigap policies across the country. Each plan offers the same benefits, no matter which insurer you choose. Insurers label the plans A through N, and each one provides different levels of coverage. Medicare no longer allows new enrollees to buy Plans E, H, I, and J.

Here’s how we describe the difference:

• Medicare Advantage plans work as “pay-as-you-go” plans. They usually have lower monthly premiums but require small copayments for services.

• Medigap plans work as “pay-in-advance” plans. The monthly premiums are higher, but they cover nearly all of your medical out-of-pocket costs under Original Medicare (except for the exclusions mentioned earlier).

If you have Medicare Advantage, you don’t need—and can’t buy—a Medigap policy.

Need Help Choosing the Right Plan?

As Independent Insurance Brokers, we work with many major insurance carriers that offer Medicare Supplement policies in Virginia and West Virginia. We can guide you through your options and help you find the best policy for your needs.

📞 Call us today at (540) 662 – 4432 or visit www.iknowmedicare.net for more information.