Medicare Suppliments and Medigap Plans





A Medicare Supplement (also called "Medigap Insurance") policy is private health insurance specifically designed to supplement the Original Medicare Plan. This means it helps pay some of the health care costs ("gaps") that the Original Medicare Plan doesn't cover (like coinsurance and deductibles). Medicare Supplement policies may also cover certain things that Medicare doesn't cover. If you are in the Original Medicare Plan and you buy a supplement policy, then both plans will pay their share of the Medicare-approved amount for covered health care costs. Medicare Supplement policies are sold by private insurance companies.

A supplement policy is not a "Medicare Advantage" (like an HMO or PPO) because it's not a way to get Medicare benefits. Insurance companies can sell you only a "standardized" Medicare Supplement policy. Standardized supplement policies are identified by letters (A through L). In some states, like Texas or Louisiana, you may be able to buy another type of Medicare Supplement policy called Medicare SELECT. Each type of supplement policy offers the same basic benefits, no matter which insurance company sells it. Usually the only difference between policies sold by different insurance companies is the cost. Medicare Supplement policies must follow Federal and state laws. These laws are designed to protect you.

What Medigap Policies Do Not Cover

Medicare Supplement policies do not cover long-term care (like care in a nursing home), vision or dental care, hearing aids, eyeglasses, and private-duty nursing. Any new supplement policy is guaranteed renewable. This means the insurance company cannot cancel your policy as long as you pay the premium. Although some policies sold in the past covered prescription drugs, no new Medicare Supplement policies are allowed to include prescription drug coverage. If you want prescription drug coverage, you may want to join a Medicare Prescription Drug Plan (Part D) offered by private companies approved by Medicare.

When is the Best Time to buy a Medicare Supplement?

The best time to buy a supplement policy is during your open enrollment period. This period lasts for 6 months and begins on the first day of the month in which you are both age 65 or older and enrolled in Medicare Part B. During this period, an insurance company can't use medical underwriting. This means it can't refuse to sell you any supplement policy it sells, make you wait for coverage to start, or charge you more for a policy read more because of your health problems. If you buy a supplement policy when you have a guaranteed issue right, the insurance company can't use a pre-existing condition waiting period at all.

Note: You can send in your application for a Supplement policy before your open enrollment period starts. This may be important if you currently have coverage that will end when you turn age 65. This will allow you to have continuous coverage. It is very important to understand your open enrollment period. During this period you can buy any supplement policy the company sells. If you apply for coverage outside of your open enrollment period, there is no guarantee that an insurance company will sell you a policy. After your open enrollment period ends, insurance companies are allowed to use medical underwriting to decide whether to accept your application and how much to charge you for the policy.

Comparing Medicare Supplement costs

The cost of supplement policies can vary widely. There can be big differences in the premiums that different insurance companies charge for exactly the same coverage. As you shop for a policy, be sure you are comparing the same type of Supplement policy.

What is Medicare SELECT?

There is another type of supplement policy called Medicare SELECT that is sold in some states, including Texas and Louisiana. Medicare SELECT can be any of the standardized Supplement Plans A through L, however, you must use specific hospitals and, in some cases, specific doctors to get your full insurance benefits (except in an emergency). Medicare SELECT policies generally cost less than other Medicare Supplement policies, however, if you don't use a Medicare SELECT hospital or doctor for non-emergency services, you will have to pay some or all of what Medicare doesn't pay. Medicare will pay its share of approved charges no matter which hospital or doctor you choose.

What is The Best Way to Find the Correct Medicare Supplement? The best way to find the best policy for your particular situation is to consult a professional who specializes in Medicare Supplements.

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