If you want to lower unexpected costs related to your hospital and medical care, you may want to think about Medicare supplement insurance. This is also known as a Medigap plan. When you have Medicare Parts A and B, a Medigap plan will cover your remaining out-of-pocket costs, including:
You can’t buy a Medigap plan if you have a Medicare Advantage plan. Medigap only works with Original Medicare (Parts A and B). It’s best to buy a Medigap policy when you’re first eligible. If you wait, private companies don’t have to let you buy their policy. Once you have Medigap, you’ll be able to keep it as long as you pay your monthly Medicare and Medigap premiums.
How Do I Shop for a Medigap Plan?
You can search for a Medigap policy online through the Medicare website. You’ll enter your ZIP code to find policies available where you live. Medigap policies come in 10 standard plans, but the costs may vary among companies. They aren’t all available in every state either. Medigap plans are usually designated with a letter A-N.
You’ll want to compare costs and what different plans offer. These benefits may include:
- Part A coinsurance and hospital costs
- Part B copays and coinsurance
- Your first 3 pints of blood if you need it
- Skilled nursing
- Excess costs for medical services
- Emergency care when you’re out of the country
Not all Medigap plans will cover all of these. Some will cover only a portion of some of these costs. So you’ll want to think carefully about the monthly premium of the Medigap plan, your health care needs, and the benefits that plan offers. Keep in mind that if you wait, you may not be able to get a particular plan.
Once you’ve found a plan you want, contact the company to get an official quote. Your monthly premium for a certain policy can change at any time.
If you apply during your Medigap open enrollment (when you first sign up for Part B), plans cannot charge you more based on your health conditions. If you apply later, however, plans can charge you more or even decline coverage altogether.
Will It Cover Hearing, Dental, or Other Services?
Generally, no. Medigap policies usually don’t cover:
- Long-term care
- Vision services or eyeglasses
- Dental services
- Private nursing
Be sure to ask and read carefully so you’ll understand exactly what the policy you want covers and what it doesn’t.
Where Can I Shop for a Medigap Plan?
To find a Medigap plan, you can search online at Medicare.gov based on your ZIP code. You’ll be able to compare:
- Monthly premiums
- Copays and coinsurance
- Plan benefits
Note that if you apply outside your Medigap open enrollment period (when you first enroll in Part B) your costs will depend on your:
You can also call and talk to someone about your options through your State Health Insurance Assistance Program (SHIP) or your State Insurance Department. The SHIPs are non-profit organizations financed by the federal government to provide free advice to you.
What Else Should I Consider Before Buying a Supplemental Medigap Plan?
If you’re thinking about a supplemental or Medigap plan, keep in mind:
- You can only buy a Medigap plan if you have Medicare Parts A and B. They don’t work with Medicare Advantage plans.
- These plans will cover some costs that your Medicare won’t. But you’ll pay an extra premium every month. Your monthly cost will depend on the plan and coverage you choose.
- Your Medigap plan will only cover you. If your spouse needs coverage, they’ll need a separate plan.
- You can choose a Medigap plan that’s offered by any insurance company licensed to sell them in your state.
- Once you have a Medigap plan, you can renew it no matter what health conditions you have. Your insurance company can’t cancel your plan as long as you don’t stop paying for it.
- As with Original Medicare, Medigap plans won’t limit your coverage to a network of providers, like a Medicare Advantage plan will.
- If you want to switch your Medigap plan later, you’ll need to check the rules. Insurance companies also may require you to pass a health screening.
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Medicare.gov: “What’s Medicare supplement insurance (Medigap)?” “Find a Medigap policy that works for you,” “How to Compare Medigap Policies.”
Office of the Insurance Commissioner of Washington State: “What is a Medigap plan and why should I buy it?” “When can I sign up or switch Medigap plans?”