Medicare Supplement Insurance

What is Medicare Supplement Insurance (Medigap)?

Medicare Supplement Insurance is sold by private companies, and assists with health care costs that are not covered by Original Medicare. Medigap policies may also cover services such as medical care when travelling outside of the United States. Learn more about Medigap.

Standardized Benefit Packages

There are 10 standard benefits packages available in all states (excluding Massachusetts, Minnesota and Wisconsin) depending on the amount of expenses that companies are willing to pay. The greater your expenses, the higher the premium will be.

Plan F is the most popular because its coverage includes everything that is not covered by Medicare. The plan additionally includes the 15% charge that is billed by doctors who refuse to accept a full payment from Medicare. Learn more about Medigap plans here.

Eligibility Before Age 65

If you are under the age of 65, you may be eligible for Medicare if you:

Receive disability benefits from Social Security for at least 24 months in a row
Have amyotrophic lateral sclerosis (ALS)
Have end-stage renal disease (ESRD) – an illness that causes permanent damage to the kidneys

Those with ALS automatically receive Medicare once Social Security disability benefits are received. However, those with ESRD need to enroll in Medicare Part A and B by visiting a Social Security Office.

Social Security Office

Locator: https://secure.ssa.gov/ICON/main.jsp

Number: 1-800-772-1213

What is Not Covered By Medigap?

Long-term care

Vision care

Dental care

Hearing aids

Eyeglasses

Private-duty Nursing

Prescription Drugs

Medicare Supplement Insurance Costs

There are 3 pricing segments: community rated or no age-rated, issue-age-rated or entry age-rates, and attained-age-rated.

Community no-age-rated:

Plans that charge premiums that are similar regardless of age

Issue-age-rated

Plans are based on your age when you first entered the agreement for the policy. Your premiums will be lower if you enrolled at a younger age.

Attained-age-rated

Plan premiums are based on the age when the policy was agreed upon, however, premiums increase as you age.

The cost of these policies ranges, and there are many difference in premiums depending on the insurance company. Read more about the costs of Medigap policies.

The Best Time to Enroll in Medigap

The best time to enroll is during the Medigap Open Enrollment Period. The Open Enrollment Period begins on the first day when you turn 65 and are enrolled in Medicare Part B, and lasts for six months. During this time, individuals can enroll in any Medigap plan offered in their area without having insurance companies charging additional fees based on medical history or other conditions. It is critical to take advantage of enrolling in a plan during this period of time.

After the Open Enrollment Period has passed, it may become more difficult to find a Medicare Supplement plan. Additionally, if there is a company that does approve your plan, premiums may be higher.

Learn more about when to buy Medigap.

Medigap FAQs

Original Medicare is a health plan based on a fee-for-service model. This plan covers both hospital insurance and medical insurance.

Fee-for-service is when services are paid for separately. Such a plan encourages physicians to treat more patients because payment depends on the amount of people that are taken care of rather than the quality of their services.

Medigap policies are available for those who have Medicare Part A and Medicare Part B.

Medicare Part A covers hospital expenses including visit, nursing care, hospice, and home health-care services. Deductibles, coinsurance and copayments may be necessary for those with Medicare Part A.

Medicare Part B covers your health insurance. Not only does it cover medical services to treat illnesses, but also the equipment necessary for one’s condition. Medical services include lab work, x-rays, surgeries, doctor’s office visits, flu shots, and cancer screenings. Medical equipment includes wheelchairs, walkers, and more.

There is no difference as Medigap is another term for Medicare Supplement Insurance. These terms are interchangeable.

Generally, any doctor that accepts Medicare will also accept Medigap.

Individuals cannot enroll into both of these plans at the same time. You will need to completely cancel one plan before enrollment in the other plan can take effect.

Generally, you will be able to travel to different states and maintain your current plan. However, it is recommended that individuals confirm with their insurance agents about whether or not their coverage will continue.

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