All About Medicare Supplement Insurance (Medigap) Coverage
Key Takeaways
Medicare Supplement Insurance (Medigap) is extra insurance that you can purchase in addition to Original Medicare (Parts A and B) .
Medigap guards Original Medicare enrollees against costly copayments , deductibles and coinsurance from certain medical treatments or lengthy hospital stays.
Medigap plans sold with Medicare policies do not cover the Part B deductible.
Whether you’re new to Medicare, or you’ve been a customer and are looking for more coverage, you may have noticed some gaps between your needs and what’s covered by Original Medicare. These gaps include coinsurance and copayment charges that can be expensive for most people. Medicare Supplement Insurance (Medigap) is a set of health insurance policies, sold by private insurance carriers, that cover these needs.
Medigap coverage typically offers:
- Different coverage levels with standard benefits for each plan.
- A range of services and plans, each assigned with a letter from “A” to “N.”
Medicare Supplement Insurance (Medigap) is only available to those enrolled in Original Medicare; it’s illegal for someone to sell you Medigap coverage if you’re enrolled in Medicare Advantage. Some plans have different benefits than others, but basic coverage is the same across most states and insurance companies. Each Medigap plan is required to follow federal and state laws to protect you and your policy.
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What’s Covered?
Not everyone will–or should–choose the most comprehensive option. When the time comes to make your choice, it’s important to know what is, and isn’t, included in each plan option.
Medigap plans are identified alphabetically from “A” to “N”, (though plans “E”, “H”, “I” and “J” are no longer sold). Plan A provides the most basic coverage, while Plan F is the most comprehensive.
Each plan has different levels of coverage, but federal law requires all Medigap plans to offer equal basic healthcare services. The decision to provide additional benefits is made on a state-by-state basis. It’s important to know which plans your state offers, as not all states offer all ten supplemental plans. Here’s a breakdown of what each Medigap plan covers.
All Medigap policies cover at least a portion of the following services:
- Medicare Part A coinsurance and hospital costs
- Medicare Part B coinsurance and copayments
- The first three pints of blood
- Part A hospice care coinsurance and copayments
Is there anything Medigap doesn’t cover?
While Medigap has several plans and coverage levels, you can’t buy a policy that covers the following:
- Long-term care
- Vision
- Eyeglasses
- Dental
- Hearing aids
- At-home or private-duty nursing care
Customers that need these services can opt for Medicare Advantage instead of Original Medicare. Medicare Advantage, or Medicare Part C, is also sold by private insurers and offers more comprehensive coverage.
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Important Notes About Medigap Coverage
As of January 1, 2020, Medigap plans sold with Medicare policies can not cover the Part B deductible. Plans C and F are not available to new enrollees joining Medicare on or after that date. Enrollees eligible for Medicare before January 1, 2020, but who have not yet enrolled, may be able to buy one of these plans.
Customers that are new to Medicare and want a comprehensive plan similar to Plans C and F may want to consider Medicare Plan G coverage because it pays for most copayments and coinsurance.
FAQs
Medigap policies only cover the actual policyholder, not spouses. If you and your spouse both need Medigap coverage, you will need to sign up separately and purchase individual policies. This can be helpful because many married couples often don’t need the same levels of care. With Medigap, you can customize each of your plans to get the value and coverage you need.
No — however, prescription drugs can be covered by the Medicare Prescription Drug Plan (Part D), which is not a Medigap plan. Medicare Part D is often sold separately from Parts A and B or is bundled with the two into a Medicare Advantage policy.
