Medicare Supplemental Insurance Plans: 10,000+ Essential Facts

What is Medicare Supplemental Insurance (Medigap)?

• Medicare Supplemental Insurance (Medigap) is private insurance that helps cover costs not paid by Original Medicare (Parts A and B).
• Medigap policies are standardized, meaning they offer the same basic coverage regardless of the insurance company you choose.
• There are 10 standardized Medigap plans available, each with different coverage options and premiums.

Who is Eligible for Medigap?

• You are eligible for Medigap if you are:
  • Enrolled in Part A and Part B of Original Medicare
  • Not enrolled in a Medicare Advantage (Part C) plan
  • A U.S. citizen or permanent resident

Benefits of Medigap

• Medigap policies can help cover a variety of costs not covered by Original Medicare, including:
  • Part A coinsurance and deductibles
  • Part B coinsurance and deductibles
  • Out-of-pocket costs for medical services received outside the U.S.
  • Medicare Part A and Part B excess charges
  • Coinsurance for skilled nursing facility stays
  • Copayments for emergency room visits

Choosing a Medigap Plan

• When choosing a Medigap plan, it is important to consider:
  • Your health needs and financial situation
  • The premiums and benefits of different plans
  • The coverage gaps of different plans
  • The reputation and customer service of different insurance companies

Costs of Medigap

• Medigap premiums vary depending on the plan you choose, your age, and the state you live in.
• According to the National Association of Insurance Commissioners (NAIC), the average monthly premium for a Medigap Plan F policy in the United States is $224.
• The average monthly premium for a Medigap Plan G policy is $166.

Enrolling in Medigap

• You can enroll in a Medigap policy during the Medigap Open Enrollment Period, which is the six-month period starting the month you turn 65 and are enrolled in Part B.
• You can also enroll in a Medigap policy during any other time of the year, but you may have to answer health questions and pay a higher premium.

Medicare Advantage vs. Medigap

• Medicare Advantage (Part C) plans are an alternative to Original Medicare and Medigap.
• Medicare Advantage plans are offered by private insurance companies and provide all the benefits of Original Medicare, as well as additional benefits, such as prescription drug coverage and vision and dental coverage.
• Medigap policies only cover the costs not covered by Original Medicare.

Is Medigap Right for You?

• Medigap is a good option for people who want to protect themselves from the high costs of out-of-pocket medical expenses.
• Medigap policies can provide peace of mind and help you budget for your healthcare costs.

Dodging the Medigap Trap

• Avoid these common Medigap pitfalls:
  • Buying a policy that duplicates your Medicare coverage
  • Buying a policy that covers less than you need
  • Paying more for a policy than you need
  • Not shopping around for the best price

Additional Resources

• Medicare.gov: https://www.medicare.gov/supplemental-insurance/medicare-supplemental-insurance-medigap/what-is-medicare-supplemental-insurance-medigap
• National Association of Insurance Commissioners (NAIC): https://www.naic.org/consumers/medicare-supplemental-insurance-medigap/
• AARP: https://www.aarp.org/health/medicare-insurance/info-2019/what-is-medicare-supplemental-insurance.html

Glossary

• Coinsurance: A percentage of a medical expense that you are responsible for paying after you have met your deductible.
• Copayment: A fixed amount that you pay for a medical service.
• Deductible: The amount you have to pay for medical expenses before your insurance coverage begins.
• Excess charges: Charges for medical services that are higher than the Medicare-approved amount.
• Out-of-pocket costs: The total amount you pay for medical expenses, including deductibles, coinsurance, and copayments.
• Skilled nursing facility (SNF): A facility that provides skilled nursing care and rehabilitation services.

Tables

Table 1: Medigap Plan Coverage