A Medicare Supplement (also known as Medigap) insurance, sold by private companies, can help pay some of the health care costs that Original Medicare doesn’t cover, like co-payments, coinsurance, and deductibles.
If you have Original Medicare and you buy a Medicare Supplement policy, Medicare will pay its share of the Medicare-approved amount for covered healthcare costs. Your Medicare Supplement Insurance policy pays its share.
A Medicare Supplement policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medicare Supplement policy only supplements your Original Medicare benefits.
Medicare Supplement Insurance Plans allow you to see any doctor who accepts Original Medicare.
For assistance in selecting a Medicare Supplement Plan please call 877-565-4728.
A Medicare Supplement (also known as Medigap) insurance, sold by private companies, can help pay some of the health care costs that Original Medicare doesn’t cover, like co-payments, coinsurance, and deductibles.
If you have Original Medicare and you buy a Medicare Supplement policy, Medicare will pay its share of the Medicare-approved amount for covered healthcare costs. Your Medicare Supplement Insurance policy pays its share.
A Medicare Supplement policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medicare Supplement policy only supplements your Original Medicare benefits.
Medicare Supplement Insurance Plans allow you to see any doctor who accepts Original Medicare.
For assistance in selecting a Medicare Supplement Plan please call 877-565-4728.
What you need to know about Medicare Supplement Insurance policies.
- You must have Medicare Part A and Part B.
- If you have a Medicare Advantage Plan, you can switch to a Medicare Supplement insurance policy, but make sure you can leave the Medicare Advantage Plan before your Medicare Supplement insurance policy begins.
- You pay the private insurance company a monthly premium for your Medicare Supplement insurance policy in addition to the monthly Part B premium that you pay to Medicare.
- A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you’ll each have to buy separate policies.
- You can buy a Medicare Supplement insurance policy from any insurance company that’s licensed in your state to sell one.
- Any standardized Medicare Supplement insurance policy is guaranteed renewable even if you have health problems. This means the insurance company can’t cancel your Medicare Supplement insurance policy as long as you pay the premium.
- Medicare Supplement insurance 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).
- 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.
Medicare Supplement policies (also known as Medigap policies) are standardized and must follow federal and state laws designed to protect you. Insurance companies can only sell you a “standardized” policy identified in most states by letters. You can see the most up-to-date Medicare Supplement standardized coverages here.
All policies offer the same basic benefits but some offer additional benefits, so you can choose which one meets your needs. As you can see in the comparison chart there are many options from which to choose. As licensed insurance agents we can help you understand the differences between the plans so that you can decide on the right plan for you.
In Massachusetts, Minnesota, and Wisconsin, Medicare Supplement policies are standardized in a different way.
Did you know that each insurance company decides which Medigap policies it wants to sell, although state laws might affect which ones they offer? Insurance companies that sell Medicare Supplement policies:
- Don’t have to offer every Medigap plan
- Must offer Medigap Plan A if they offer any Medigap policy
- Must also offer Plan C or Plan F/G if they offer any plan
Keep in mind, that the Medicare Supplement policy covers co-insurance after you’ve paid the deductible (unless the Medigap policy also pays the deductible).
For assistance in selecting the right Medicare Supplement Plan for your needs please call 877-565-4728.
When to Enroll?
Open Enrollment Period: The best time to enroll in a Medigap policy is during your Medigap Open Enrollment Period. This period starts the first month you’re both 65 or older and enrolled in Medicare Part B, and it lasts for six months. During this time, insurance companies are generally required to sell you any Medigap policy they offer, regardless of your health, and they can’t charge you more due to pre-existing conditions.
Guaranteed Issue Rights: Outside of the Medigap Open Enrollment Period, you may still have the opportunity to switch Medigap policies with guaranteed issue rights if you meet certain criteria. For example, if you lose your existing coverage (e.g., if your Medigap insurer goes bankrupt) or if you move out of your plan’s service area, you may have the right to purchase a new Medigap policy without medical underwriting.
Underwriting and Pre-Existing Conditions: If you switch Medigap policies outside of your Medigap Open Enrollment Period and don’t have guaranteed issue rights, you may be subject to medical underwriting. This means that the insurance company can consider your health status and may charge you a higher premium or deny coverage based on your pre-existing conditions.
It’s essential to carefully review your options and consider your individual circumstances before enrolling in Medigap coverage. It’s a good idea to consult with a licensed insurance agent or contact your State Health Insurance Assistance Program (SHIP) for personalized guidance.
Can I Change Plans?
That depends…
If you live in New York or Connecticut you can switch Medigap(Medicare Supplement) plans any time of year for any reason. No health questions or underwriting. You can switch from Medicare Advantage Part C to a Medicare Supplement plan during the Annual Enrollment Period from Oct 15th to Dec 7th. Those lucky enough to live in these two states can shop for the lowest-cost plan every year.
If you live in Florida you can switch Medigap(Medicare Supplement) plans on your birthday: If you already have Medigap, you have a two-month period annually where you can switch to another Medigap plan from any company, as long as the plan has the same or lesser benefits. The guaranteed issue period starts on the first day of your birthday month
If you live in Virginia, Pennsylvania, or New Jersey you can change plans any time of year, but you will have to answer health questions and go through underwriting, and your application is not guaranteed to be approved. You may be declined or charged a higher rate.
It’s essential to carefully review your options and consider your individual circumstances before making any changes to your Medigap coverage. Additionally, if you’re considering switching policies, it’s a good idea to consult with a licensed insurance agent or contact your State Health Insurance Assistance Program (SHIP) for personalized guidance.
