Medicare Supplement Insurance Explained: What You Need to Know

Medicare Supplement Insurance Explained: What You Need to Know

Medicare Supplement Insurance is also known as Medigap. The policy adds an extra layer of protection to original Medicare policies. Medicare Supplement Insurance is sold by private companies. It generally covers health care expenses such as co-pays, co-insurance, and deductibles. Medigap has unique benefits that original Medicare policies don’t provide. For example, original Medicare policies do not cover treatment if you need emergency medical care while on vacation outside the United States, whereas Medigap covers you under such circumstances.

How to Get Started with Medicare Supplement (Medigap)?

  • Qualifying for Medigap

    In order to qualify for Medicare Supplemental Insurance, you must have Medicare Part A and B. Remember that there are differences between Medigap policies and Medicare Advantage Plans. Medicare Advantage Plans are not supplemental policies; instead, they are ways to get your Medicare benefits. Medigap policies, on the other hand, supplement the original Medicare benefits.

  • Retaining Your Medigap

    To retain your Medicare Supplemental Insurance, you have to pay a monthly premium to your insurer. This amount is to be paid in addition to the Part B premium that you pay for your original Medicare policy. Note that Medicare Supplemental Insurance policies only cover one person. Therefore if both you and your spouse need Medigap coverage, you will have to buy separate policies.

  • Research Prospective Insurers

    Research all of the insurance companies in your state that are licensed to sell Medicare Supplemental Insurance. It is illegal for anyone to offer you a Medicare Supplemental Insurance policy if you have a Medicare Advantage Plan. The only exception is if you are planning to switch back to an original Medicare plan.

  • Period and Extent of Coverage

    All standard Medicare Supplemental policies are renewable even if you have a diagnosed health problem. As long as you meet your premiums, your policy will not be canceled. Generally, most Medicare Supplemental policies do not cover prescription drugs. If you want that type of coverage, you can purchase a Medicare Prescription Drug Plan (Part D).

  • If you opt for supplemental coverage and purchase a Medicare Drug Plan, you may have to pay separate premiums for each.

    It’s also important to note that supplemental plans sold to people who are newly eligible for Medicare do not qualify for the Part B deductible. However, if you were eligible for Medicare before January 1, 2020, but had not enrolled, you can purchase a plan that covers the Part B deductible.

    Plans C and F also aren’t available for the newly eligible; however, if you had these plans before January 1, 2020, you can continue with them.

    Note that Medicare Supplemental Insurance policies do not cover private nursing, dental, or vision care.

    Some common insurance plans that are not Medigap plans include:

  • Employer/Union Plans
  • Veterans’ Benefits
  • Medicare Prescription Drug Plans
  • Medicaid
  • Medicare Advantage Plans (like an HMO, PPO, or Private Fee-for-Service Plan)

If you want a new Medicare Supplemental Insurance policy, make sure to evaluate your options carefully. Pay close attention to the deadlines to avoid a late enrollment fee. If you have any questions regarding Medicare, contact us at Medicare Advisors today! Our experts will help you evaluate your choices.