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Medigap (Medicare Supplement Insurance) Policies

Medigap policies are designed to help cover costs for people on the Original Medicare Plan. Medigap policies cover amounts not covered under the Original Medicare Plan alone, such as copayments, coinsurance, and deductibles. Medigap policies may also cover additional benefits, such as hearing or vision coverage, for an extra cost.

If you have a Medicare Advantage plan, you will not need and cannot buy a Medigap policy. Insurance companies can only sell standardized Medigap policies usually identified by the letters A-L (although policies may be standardized slightly differently in Massachusetts, Minnesota, and Wisconsin). You usually must have both Medicare Part A and Medicare Part B to be eligible to buy a Medigap policy. Each company that sells Medigap policies can choose which of the standard plans it wants to sell, but can choose different costs and premiums for the services it covers.

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You have a Medigap open enrollment period beginning the first day of the month when you are both 65 and enrolled in Medicare Part B. If you buy a Medigap policy during this time, the insurance company must sell you any Medigap policy it sells, cannot make you wait for coverage to start, and cannot charge you more for your Medigap policy based on your health.

New Medigap policies are not permitted to offer prescription drug coverage*. You may have a Medigap policy with prescription drug coverage if you purchased your plan before 2006. The types of benefits covered vary by Medigap policy. You will want to compare both the different types of Medigap policies and the costs charged by the different companies that offer the type of plan you are interested in. Medigap policies may cover such things as:

• Coinsurance for inpatient hospital care
• Some or all of Medicare Part B coinsurance amounts
• Some or all of the first three pints of blood you receive
• Part of copayment or coinsurance for hospice care
• Coinsurance for care in a skilled nursing facility
• Medicare Part A or Part B deductibles
• Overseas emergency coverage
• Preventive care coinsurance

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