Medicare Supplement Plans are optional plans sold by private insurance companies.
These optional plans, also called Medigap, can help reduce your out-of-pocket costs.
Medigap can be used to pay for Medicare deductibles and copayments, as well as other costs depending on the plan.
Medigap plans can’t be combined with Medicare Advantage plans.
Medicare Supplement Plans, also known as Medigap plans, are optional private insurance that you can add on to Original Medicare. These plans can be used to help pay for a portion of Medicare-covered services.
There are several types of Medigap plans, and each offer different coverage, rates and availability. Medigap plans are private insurance plans, but you might not be able to find the same plans or rates everywhere. You will need to check with the insurance companies in your area to find out what plans are offered and how much they cost.
Find a local Medicare plan that fits your needs
There are 12 types of Medigap plans, including two plan types — G and F — that offer high-deductible versions. This means that if you agree to pay a higher deductible when you receive care, you can lower your monthly premium payment.
Each Medigap plan type must cover at least a minimum set of services that are dictated by the federal government. Beyond that, each insurance company has some room to tailor individual plans and prices.
All D.C. Medigap plans will cover:
- Medicare Part A coinsurance for hospital and hospice care
- Medicare Part B coinsurance and copayments
- Blood needed for medical procedures (first 3 pints in a year)
Some D.C. Medigap plans will also cover:
- Part A coinsurance for skilled nursing care facility
- Part A deductible
- Part B excess charges
- Up to 80% of foreign travel emergency healthcare
You can compare each of the 12 available Medigap plans in this side-by-side comparison chart. All of these plans are offered in D.C., but specific prices and additional services of availability can vary from one insurance company to the next.
Plans C and F are the only exception, as these can no longer be sold to people who became eligible for Medicare after January 1, 2020. This is the result of a change that prohibits plans from fully covering Part B deductibles after that date.
Rates of Medigap plans can vary based on the insurance company offering the plan. Some plans also determine costs based on your age, while others price premiums based on the market rather than age.
Monthly Medigap premiums will depend on which plan you select and the company that offers it. With most plans, there is a small copayment or none at all for Part B services after your annual deductible is met.
Are you eligible for cost-saving Medicare subsidies?
If you are eligible for Original Medicare, you can purchase a Medigap plan. However, if you don’t buy a Medigap plan when you first become eligible for Medicare, there’s no guarantee you will be able to buy a plan later on — or it could cost you more.
You will get the best prices and the most choices if you purchase a Medigap plan during the initial six-month open enrollment period. This period begins the first month you have Medicare Part B coverage. After this initial period, you may not be able to buy a plan at all, because insurance companies can opt to decline coverage based on your pre-existing health conditions.
If you add Medigap to your Original Medicare, you should start by reviewing the different types of plans to see what will best fit your needs and budget. Next, compare which insurance companies offer those plans. You can use Medicare’s online plan finder tool to help you locate plans and providers in your zip code. Or you can call GoHealth to speak to one of our licensed insurance agents, who can help you compare Medigap plans to find the one that will best fit your needs.
Medigap plans were allowed to include prescription drug coverage before 2006. If you bought one of these plans, you can keep the coverage, but if you ever drop your drug coverage you won’t be able to add it back on later.
While you can’t wrap prescription coverage into your Medigap plan anymore, you can still get medication coverage through Medicare. To get prescription drug coverage, you will need to purchase a Medicare Part D plan.
If you do have drug coverage from a Medigap plan purchased before 2006, you cannot be enrolled in a Part D plan at the same time.
What extra benefits and savings do you qualify for?
Medigap plans can only be added to Original Medicare. If you have a Medicare Advantage plan, you will need to cancel your Medigap policy.
Medicare Advantage combines all the elements of Original Medicare plus extra services like drug coverage, high-deductible plans and more. If you switch from Original Medicare with a Medigap plan to a Medicare Advantage plan and you’re not happy with your choice, you will have a one-time, 12-month grace period during which you can get your Medigap plan back or buy a different one.
You need to qualify for Original Medicare to purchase a Medigap plan. If you don’t sign up during your initial signup period, which is a six-month period that begins when you enroll in Medicare Part B, the insurance company providing the plan can also deny you coverage based on your health or other health conditions.
The price of your Medigap plan can range based on the type of plan you choose, what services are covered and the company that provides the plan. Most plans require a monthly premium payment, and sometimes a share of things like copayments and deductibles for different types of services.
Today, you can only add drug coverage with the purchase of Medicare Part D. However, if you purchased your Medigap plans before January 1, 2006, it might cover prescription medications and you can keep the coverage. However, if you ever drop this coverage or change your plan, you won’t be able to get drug coverage with your Medigap plan again.
Medicare Advantage plans are already designed to provide additional services and cover some out-of-pocket costs, so Medigap plans can only be added to Original Medicare. You cannot have a Medicare Supplement Plan with a Medicare Advantage plan.
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