A Medicare supplement plan is also known as a Medigap policy and is designed to cover extra costs that may not be covered by your Original Medicare policy. Unlike federally provided Medicare policies, Medigap coverage must be purchased through a private insurer.
To qualify for a Medigap policy, you must:
- Be 65 years old or older
- Already have Medicare Part A and Part B
- Purchase through a private insurer
- Pay monthly premiums in addition to your Plan B Medicare premiums
- Not have Medicare Advantage
Medigap coverage is not a replacement for Original Medicare or Medicare Advantage. You cannot purchase Medigap coverage if you have a Medicare Advantage plan unless you are switching back to Original Medicare.
What Does Medigap Cover?
Since Medigap is designed to fill in the gaps left by your Original Medicare, it does not cover long-term care or dental procedures. A basic Medigap policy instead covers copayments, coinsurance and deductibles. Some Medigap policies can also cover expenses for medical care you may receive while outside of the U.S. As of 2006, Medigap policies no longer cover expenses related to prescription drug costs. If you have any questions about your Original Medicare, Medigap or Medicare Advantage plan, be sure to speak with your insurance agent. It is critical that you know what you are covered for before an accident ever occurs.
When Can I Buy Medigap Coverage?
You should be able to purchase a Medigap policy during the open enrollment period that begins the month you turn 65. Outside of this enrollment period, it could be difficult or even impossible to get Medigap coverage depending on the insurer and your qualifications. The main exceptions for those who want to purchase Medigap insurance outside of the open enrollment period are people who have a disability or End-Stage Renal Disease (ESRD), have pre-existing conditions or other health problems.
Can I Buy Medigap for Me and My Partner?
Unfortunately, Medigap policies come separately to cover only a single person. If you and your spouse both need Medigap insurance, you will have to purchase two separate policies. Be sure to track both of your open enrollment periods. For some qualifying seniors, enrollment is automatic once they turn 65 years old. Delaying or missing your open enrollment period for Medicare and Medigap can cause you issues in the future when it comes to paying for important medical bills.
https://www.medicare.gov/supplements-other-insurance/when-can-i-buy-medigap
FAQ’s About How Do I Get a Medicare Supplement Plan?
What is a Medicare Supplement Plan?
A Medicare Supplement Plan, also known as Medigap, is an insurance policy provided by private companies to cover gaps in Original Medicare (Part A and Part B) coverage, such as deductibles, coinsurance, and copayments.
How do I qualify for a Medicare Supplement Plan?
To qualify for a Medicare Supplement Plan, you must be enrolled in Medicare Part A and Part B. You also need to be 65 or older, although some states offer Medigap policies to people under 65 with certain disabilities or conditions.
When is the best time to enroll in a Medicare Supplement Plan?
The best time to enroll in a Medicare Supplement Plan is during your Medigap Open Enrollment Period, which starts on the first day of the month that you are both 65 or older and enrolled in Medicare Part B. This period lasts for six months and guarantees you the right to buy any Medigap policy sold in your state, regardless of health issues.
Can I switch Medicare Supplement Plans at any time?
Yes, you can switch Medicare Supplement Plans at any time; however, if you do so outside of your Medigap Open Enrollment Period or certain special circumstances, you may have to undergo medical underwriting and could be denied coverage or charged more based on your health status.
What does a Medicare Supplement Plan cover?
Medicare Supplement Plans help cover some of the costs not paid by Original Medicare, such as copayments, coinsurance, and deductibles. Some plans also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S.
How many different Medicare Supplement Plans are available?
There are 10 standardized Medicare Supplement Plans available in most states, labeled A through N. Each plan offers a different combination of benefits, with Plan A providing the fewest benefits and Plan F covering the most.
Does a Medicare Supplement Plan cover prescription drugs?
No, Medicare Supplement Plans sold after January 1, 2006, do not include prescription drug coverage. To get prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D).
How do I choose the right Medicare Supplement Plan for me?
To choose the right Medicare Supplement Plan, compare the benefits and costs of the different plans. Consider your health needs, budget, and preferences for how much coverage you want versus how much you’re willing to pay in premiums. It might also be helpful to review your past medical expenses to estimate future costs and decide which plan aligns with your healthcare needs.
Will a Medicare Supplement Plan cover my spouse as well?
No, Medicare Supplement Plans do not cover spouses. Each person must purchase their own individual Medigap policy. If both you and your spouse want supplemental coverage, you’ll each need to buy a separate plan.
Are Medicare Supplement Plans affected by any changes in Medicare laws?
Medicare Supplement Plans are standardized and must conform to federal and state laws designed to protect consumers. If Medicare laws change, Medigap policies may also change to align with those laws. However, any changes to your existing Medigap policy will be communicated to you by your insurance provider, and your benefits will not be canceled as long as you pay your premiums.