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What Is Medigap and What Does It Cover?

By Ashley Hinson
Medigap policies supplement Original Medicare by covering deductibles, copays, and coinsurance.

Medicare Supplement insurance, or Medigap, is one way to lower or eliminate costs. For those using Original Medicare, Medigap plans offer supplementary Medicare coverage. Read on to learn more about Medigap policies and costs.

What is Medicare Supplement (Medigap?)

Medicare Supplement, also called Medigap insurance, partners with Original Medicare (parts A and B) to cover gaps in Medicare coverage.

“Medigap technically is Medicare supplement insurance. It covers Medicare’s original out-of-pocket costs. In Original Medicare, not everything is covered 100 percent. You have deductibles, copay, and coinsurance—and the Medigap plan picks up that cost,” licensed insurance agent Christian Worstell at MedicareAdvantage.com tells WebMD Connect to Care.

Some Medigap plans will also cover additional hospital days, your first three pints of transfused blood, and some foreign travel emergency care, Jacob Klingenberg, licensed insurance agent and founder of TrueVine Group,  tells WebMD Connect to Care. 

When using Medigap for medical care outside of the U.S., “Medicare will pay its share of covered costs, and then Medigap will pay its share. Just flash both your red, white, and blue Medicare Card and your company-branded Medigap card. You are stuck with any of the bill remaining,” Klingenberg says. 

While Medigap can help you cover some of the costs that Original Medicare won’t, Medigap policies generally do not cover services like vision or dental care, long-term care, hearing aids, eyeglasses, or in-home nursing.

Medicare standardizes Medigap into 10 lettered plans, A-N. Private insurers sell these standardized plans to Original Medicare recipients, and the specific private insurers and associated fees will vary according to your region and state.

All Medigap policies cover the same basic benefits, but some plans offer more benefits than others. Additionally, new enrollees are not eligible for Medigap plans C and F as of January 1, 2020. 

You can use the official U.S. government website for Medicare website to compare the coverage of various policies against your needs in order to determine which one is right for you. 

Medigap Costs

You’ll pay a private insurance company a monthly premium for your Medigap coverage. This premium is in addition to the monthly premium that you’ll continue paying for Original Medicare Parts A and B. 

Costs vary based on coverage as well as location. “Expect to spend $100 or more (a month) on a more high quality plan in a more competitive market, or $30 a month in another market,” Worstell says. 

“If the consumer isn’t in an open enrollment period or doesn’t have a guaranteed issue right, medical factors may affect costs. A big factor to be aware of is different insurance companies charge different prices for the exact same plan. The difference in price can sometimes be staggering,” Klingenberg says.

Other factors to consider include your age, gender, tobacco use, and household discounts, according to Klingenberg. 

Medigap vs. Medicare Advantage

If you enroll in a Medigap plan, you become ineligible to enroll with Medicare Advantage, also known as Medicare Part C. “Medicare Advantage covers the public part of Medicare and allows it to include extra benefits: dental, vision, prescription drugs, hearing aids,” Worstell says. 

Klingenberg says factors to consider when choosing between Medicare Advantage and Medigap plans include income, budget, assets, health and health history, lifestyle, travel, the specific doctors you'd like to see, and your needed prescriptions. 

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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.