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MEDICARE SUPPLEMENT 

MEDIGAP

A Medicare Supplement or Medigap Plan is a health plan provided by an insurance company that helps cover the ‘gaps’ in Medicare coverage. There are several different types of plans. All plans are regulated by state and federal guidelines, but not all states have all plans. You will want to speak to me if you have a question about what plans are available.

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These plans cover some of the deductibles and the co-insurance payments for Medicare Part A (Hospital) and Medicare Part B (Medical) coverage.

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These plans are separate from Medicare but work directly with Original Medicare.Something to remember about Medicare Supplements: They do not cover prescription drugs. Since 2006, no new Medicare Supplement Policy covers prescription drugs. They are covered by Medicare Part D Prescription Drug Plans.

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8 THINGS YOU NEED TO KNOW

  1. You must have Medicare Part A and Part B.

  2. A Medigap policy is different from a Medicare Advantage Plan.  Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.

  3. You pay the private insurance company a monthly premium for your Medigap policy. You pay this monthly premium in addition to the monthly Part B premium that you pay to Medicare.

  4. A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you'll each have to buy separate policies.

  5. You can buy a Medigap policy from any insurance company that's licensed in your state to sell one.

  6. Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can't cancel your Medigap policy as long as you pay the premium.

  7. Some Medigap policies sold in the past cover prescription drugs. But, Medigap policies sold after January 1, 2006 aren't allowed to include prescription drug coverage. If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D).

  8. It's illegal for anyone to sell you a Medigap policy if you have a Medicare Advantage Plan, unless you're switching back to Original Medicare.

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INSURANCE PLANS THAT AREN'T MEDIGAP

  • Medicare Advantage Plans (like an HMO, PPO, or Private Fee-for-Service Plan)

  • Medicare Prescription Drug Plans

  • Medicaid

  • Employer or union plans, including the Federal Employees Health Benefits Program (FEHBP)

  • TRICARE

  • Veterans' benefits

  • Long-term care insurance policies

  • Indian Health Service, Tribal, and Urban Indian Health plans

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