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5 Things To Know About Medigap Policies

By Kyle Kirkland
Medigap insurance offers extra coverage that you cannot get through Original Medicare.

Medigap insurance, also known as Medicare Supplement, is a type of insurance that covers certain healthcare costs that Original Medicare (Parts A and B) doesn’t. Medigap can be a good option if you need extra coverage for healthcare costs beyond what Original Medicare provides. Read on for some key facts about Medigap. 

Medigap Can Cover Increased Costs Associated with Aging

“Medigap policies are going to provide more protection and less out-of-pocket expense as clients get older and less healthy,” Katherine Adams, founder of the Creative Legacy Group insurance company, tells WebMD Connect to Care.

With Medigap, you pay a private insurance company a monthly premium to cover the gaps in your Original Medicare coverage, including:

  • Copays
  • Coinsurance
  • Deductibles

“I always recommend that, if a client can afford the monthly payments, to get a Medigap because as their health declines, they will be subject to less out-of-pocket expenses,” Adams says.

The lure of saving money can cause people to get excited and therefore not be aware of potential scams. You can use the official U.S. government website for Medicare to help make sure that you are receiving the correct information and enrolling appropriately. 

Medigap Can Cover International Healthcare Expenses

The official U.S. government website for Medicare reports that someMedigap plans will cover your health care expenses while you are outside of the United States. More specifially, Medigap Plans C, D, E, F, G, H, I, J, M, and N:

  • Cover emergency care needs that occur during the first 60 days of your trip outside of the U.S.if Medicare doesn't already cover the care
  • Cover 80% of your billed costs for some types of medically-necessary emergency care outside of the U.S.—after you've met your $250 yearly deductible

Medigap Offers Plans for Individuals

Medigap plans only offer coverage for one person at a time. If you have a spouse who needs coverage, you will need to purchase a second plan for them.

Medigap Plans are Standardized

There are 10 standardized Medigap plans that private insurance companies adhere to, but the specific companies available to you will depend on your region and state. 

“This means that, in most cases, a Plan letter offers the same benefits, covers the same doctors, and pays claims the same—regardless of the company,” Travis Price, Medicare and Final Expense Insurance Agent, tells WebMD Connect to Care.

Even though you can purchase Medigap from different companies, this consistency makes the process easier to understand.

“In other words, a Plan G is a Plan G, regardless of if you use a brand name company or Bob's Backyard Medicare Supplement company. Price is the primary difference between Medicare Supplement plans,” Price says.

Medigap Doesn’t Cover Everything

According to the official U.S. government website for Medicare, Medigap plans won't generally cover the following:

  • Long-term care
  • Vision care
  • Dental care
  • Hearing aids
  • Eyeglasses
  • Private, at-home nursing

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Interested in learning more about Medicare, Medigap, and Medicare Advantage plans? WebMD Connect to Care Advisors may be able to help.