What is Medigap, and Why Do I Need Supplemental Insurance?
Private insurance companies offer Medicare Supplement Insurance (Medigap) to help cover some of the healthcare costs not covered by Original Medicare (Part A and B).
You may need to add Medicare Supplement Insurance to fill costly “gaps” in coverage. Private insurance companies provide Medigap plans with different levels of coverage.
Medigap coverage can help you eliminate cost gaps. It’s important to know what you need and compare plans to determine which Medigap plan is right for you.
What is Medigap Insurance?
Original Medicare (Part A and Part B) requires beneficiaries to still pay copays, deductibles, and co-insurance. Medicare Supplement Insurance, or Medigap policies, help you cover some of the costs Original Medicare doesn’t. Frequent hospital or doctor visits can be expensive without the right coverage.
A Medicare Supplement insurance plan offers:
- Different coverage levels with standard benefits for each plan.
- A range of services and plans, each assigned a letter from “A” to “N.” It’s important to note plans “E”, “H”, “I” and “J” are no longer sold.
- Basic Medigap coverage is the same across most states and insurance companies.
- Each Medigap plan follows federal and state laws to protect you and your policy.
The terms “standard benefits” and “basic coverage” mean that Medigap plan “A” in one state is the same as Plan “A” in a different state. However, there are exceptions to this rule with a few states.
What Do Medigap Plans Cover?
Medicare Supplement plans cover some costs not covered by Original Medicare. For example, a 20% co-insurance bill for a doctor visit could be covered with a Medigap plan. All Medicare Supplemental insurance plans must cover standard services. Additional benefits are available with specific plans.
All Medicare Supplemental insurance plans must cover:
- Medicare Part A co-insurance costs up to an additional 365 days after Medicare benefits run out; co-insurance or copayments for hospice care
- Medicare Part B co-insurance or copayments
- Up to three pints of blood
Other services covered depending on the plan:
- Skilled nursing facility care co-insurance
- Part A deductible
- Part B deductible (no longer covered for new Medicare beneficiaries)
- Part B excess charges
- Foreign travel emergency care
Medicare Supplement plans generally don’t cover:
- Prescription drugs
- Long-term care
- Hearing aids