What Are Medigap Plans?

Medigap is extra health insurance that you buy from a private company to pay for services that Original Medicare doesn't cover.

You pay a monthly premium for a Medigap policy. However, if you use health services not covered by Medicare, your Medigap policy may save you money in the long run. You have to decide whether paying for a Medigap policy makes sense for you.

Medicare Benefits: How Do I Get a Medigap Plan?

Medigap policies are only available to people who already have Medicare Part A for hospital services and Medicare Part B for doctor services. People who have a Medicare Advantage plan cannot get a Medigap plan (and shouldn't need one.)

To learn about Medigap plans offered in your area, you can use the online Medicare Personal Plan Finder or contact your state's department of insurance.

There are 12 standard Medigap plans, labeled A through L, that offer different levels of health coverage, Even though different insurance companies sell these policies, the benefits of each standard Medigap plan are always the same.  For instance, a Medigap Plan E policy should offer set benefits no matter which company you buy it from.

If you are going to buy a Medigap plan, do it within six months of taking Medicare Part B -- this is called your Medigap open enrollment period.  If you try to buy a Medigap policy after six months, there is no guarantee that you'll be able to get coverage.  If you do get covered, your rates might be higher.

How Much Does a Medigap Plan Cost?

You pay a monthly premium to the insurance company in addition to your Medicare Part B premium. The cost of your Medigap policy depends on the type of plan you buy, the insurance company, your location, and your age. 

Insurance companies set their own prices and rules about eligibility, so it's important to shop around.

What Does Medigap Cover?

Most Medigap plans help pay for some of your Medicare co-payments, co-insurance for hospital stays, and some other services.

Cheaper plans have fewer benefits and higher out-of-pocket costs. More expensive plans include extra benefits, like coverage for routine checkups, some Medicare deductibles, at-home recovery, and more. You have to decide what sort of plan makes the most sense for you.

Medigap: What Else Do I Need to Know?

• Some Medigap plans used to cover prescription drugs.  Since the introduction of the Medicare Prescription Drug Plan, you can no longer sign up for these plans. If you already have a Medigap plan that covers drugs, however, you can keep it.
  
• For more information about Medigap plans, see the Medicare web site at www.medicare.gov or call 800-MEDICARE.