A Medicare Supplement (Medigap) insurance, sold by private companies, can help pay some of the health care costs that Original Medicare doesn’t cover, like co payments, coinsurance, and deductibles.
Some Supplement policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Supplement policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Supplement policy pays its share.
- You must have Medicare Part A and Part B.
- If you have a Medicare Advantage Plan, you can apply for a Supplement policy, but make sure you can leave the Medicare Advantage Plan before your Supplement policy begins.
- You pay the private insurance company a monthly premium for your Supplement policy in addition to the monthly Part B premium that you pay to Medicare.
- A Supplement policy only covers one person. If you and your spouse both want Supplement coverage, you’ll each have to buy separate policies.
- You can buy a Supplement policy from any insurance company that’s licensed in your state to sell one.
- Any standardized Supplement policy is guaranteed renewable even if you have health problems. This means the insurance company can’t cancel your Supplement policy as long as you pay the premium.
- Some Supplement policies sold in the past cover prescription drugs, but Supplement policies sold after January 1, 2006 aren’t allowed to include prescription drug coverage. If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D).
- It’s illegal for anyone to sell you a Supplement policy if you have a Medicare Medical Savings Account (MSA) Plan.
Supplement policies don’t cover everything
Supplement policies generally don’t cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.
Insurance plans that aren’t Supplement
Some types of insurance aren’t Supplement plans, they include:
- 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
Dropping your entire Supplement policy (not just the drug coverage)
If you decide to drop the entire Supplement policy, you need to be careful about the timing. For example, you may want a completely different Supplement policy (not just your old Supplement policy without the prescription drug coverage), or you might decide to switch to a Medicare Advantage Plan that offers prescription drug coverage.
If you drop your entire Supplement policy and the drug coverage wasn’t creditable or you go more than 63 days before your new Medicare coverage begins, you have to pay a late enrollment penalty for your Medicare Prescription Drug Plan, if you choose to join one.
Contact our office to find out which plan best fits your needs. Phone: 800-763-1406