Medigap Plans
- Medigap is private health insurance that fills some of the gaps in
Original Medicare coverage. It does not cover most services that fall outside of
Medicare’s realm of coverage, such as long term care.
- Of the 12 standard Medigap plans offered (labeled A through L), the most popular
are C and F, because they cover major benefits and are less expensive than other
plans.
- Medigap plans require a premium in addition to the premium charged by Medicare for
Part B coverage. A Medigap plan typically reduces or eliminates your loved one’s
deductibles and copayments.
Next Step
To find the best Medigap plan for your loved one, compare the many different types
of plans available.
Compare now
You may have noticed that Original Medicare doesn’t cover everything your loved
one might need, and that deductibles, coinsurance, and other out-of-pocket costs
can quickly add up. Private health insurance companies sell Medicare supplemental
insurance, known as Medigap, to fill gaps in coverage and limit out-of-pocket expenses.
These plans add to your loved one’s Original Medicare plan, rather than replacing
it. Medigap plans cover all the same services as Original Medicare but typically
require less cost-sharing, reducing the amount your loved one pays out of pocket.
A Medigap plan may also cover services such as routine check-ups, hearing aids,
and vision care, and may broaden your loved one’s range of choice in providers.
Plans A Through L
Most states offer 12 standard Medigap plans, labeled A through L, each of which
varies in the level of coverage and benefit provided, with Plan A being the most
basic. (Massachusetts, Minnesota, and Wisconsin have a different set of plans; contact
your State Health Insurance Assistance Program (SHIP) for details.) Not all insurance
companies offer all 12 plans. To compare different plans, see our chart.
Comparing Different Plans
Shopping for a Medigap policy can be confusing. Be sure to carefully review each
policy’s details, including features such as the right to renew and exclusions for
pre-existing conditions.
Most Medigap companies have agreements with Medicare to receive claims directly
so you don’t have to submit claims--be sure to ask the insurance company if it has
a “crossover” arrangement with Medicare. Insurance companies are required to offer
a 30-day “free look” period for Medigap plans, during which your loved one can cancel
for a full refund.
Each of the Medigap plans costs a different amount, and each health insurance company
may charge a different premium on top of what your loved one pays for Part B coverage.
Medicare’s
Find and Compare Medigap Policies can help you identify potential policies
for your loved one. Follow up with insurance companies to get precise quotes.
More Affordable Options
Insurance companies offer MedicareSELECT plans in some states. These cost less than
other Medigap policies but restrict your choice of providers, much like an HMO plan.
Check with your local SHIP office for details. Your loved one may also be able get
supplemental insurance from a former employer as a retiree benefit. For additional
government options, see Medicare Assistance Programs.
Next Step: To find the best Medigap plan for your loved one, compare the many different types of plans available. Compare Now
