Medicare Supplement/Medigap Insurance
Fill the gaps in Original Medicare with a standardized supplement plan that travels with you anywhere in America.
What Is Medicare Supplement/Medigap?
A Medicare Supplement policy is an insurance policy that helps fill "gaps" in Original Medicare. Medicare Supplement Insurance (also called Medigap) is private health insurance designed to help pay some of the healthcare costs that Original Medicare (Parts A & B) doesn't cover — such as copayments, coinsurance, and deductibles.
Because Original Medicare typically pays 80% of approved costs, a Medigap policy can cover the remaining 20%, giving you predictable out-of-pocket expenses and peace of mind.
Medigap policies are standardized by the federal government and sold by private insurance companies. Each plan is labeled with a letter (Plan A, Plan B, Plan G, Plan N, etc.), and every insurer must offer the same basic benefits for each lettered plan — so the main difference between companies is price and service.
Unlike Medicare HMO and PPO type plans with networks, restricted service areas, referrals, and prior authorization rules and regulations, Medigap plans have no networks — so you can see any provider (doctors or hospitals) anywhere in America that accepts Medicare. Total freedom to always choose from the finest doctors or hospitals anywhere in America.
If you have Original Medicare A & B and a Medigap policy, Medicare will pay its share of the Medicare-approved medically necessary fees for covered health care services. Then, your Medigap policy pays its share to your provider. Medicare doesn't pay any of the costs of buying a Medigap policy.
A Medigap policy is different from a Medicare Advantage Plan because those plans are another way to get your Part A and Part B benefits, while a Medigap policy only helps pay for the costs that Original Medicare A & B doesn't cover. Insurance companies can't sell you a Medigap policy if you have coverage through a Medicare Advantage Plan or Medicaid. In other words, you can't have both, either one or another.
Additionally, there is a monthly premium for a Medigap plan that typically increases each year as members get older, so it's an economic issue which might deter a Medicare beneficiary from choosing a Medigap plan either when first eligible for Medicare or sometime afterwards.
Finally, the law requires a prescription drug plan for all beneficiaries over 65, so a stand-alone PDP (Prescription Drug Plan) must be purchased when enrolled in a Medigap plan — otherwise the member is subject to a PDP penalty of 1% per month for every month without a drug plan.
Enrollment Eligibility
The best time to enroll in a Medicare Supplement/Medigap plan is during your Medicare Supplement/Medigap Open Enrollment Period — the 6-month window that begins the month you turn 65 and are enrolled in Medicare Part B. During this period, insurers cannot deny you coverage or charge higher premiums based on pre-existing conditions. Outside this window, medical underwriting may apply.
Not Sure Which Plan Is Right for You?
Every person's health situation and budget is different. We'll analyze your doctors, medications, and finances to recommend the Medicare Supplement/Medigap plan that fits you best — at no cost to you.