What is Medigap Coverage? A Complete Guide to Medicare Supplement Insurance
What is Medigap?
Medigap (Medicare Supplement Insurance) is private insurance designed to help fill the "gaps" in Original Medicare coverage. These policies help pay for out-of-pocket costs like copayments, coinsurance, and deductibles that Original Medicare doesn't cover.
How Does Medigap Work?
To have a Medigap policy, you must have Medicare Part A and Part B. When you visit a doctor or hospital, Medicare pays its share of approved charges first, then your Medigap policy pays its share. This coordination helps reduce your out-of-pocket healthcare costs significantly.
Key Insight
Medigap policies are standardized. Every Medigap policy with the same letter offers the same basic benefits, regardless of which insurance company sells it.
What Does Medigap Cover?
Part A Coinsurance and Hospital Costs
Coverage for up to 365 additional days after Medicare benefits are exhausted
Part B Coinsurance or Copayment
Covers the 20% coinsurance for Medicare-approved services
Blood (First 3 Pints)
Coverage for the first three pints of blood each year
Foreign Travel Emergency
Up to plan limits for emergency care outside the United States
Popular Medigap Plans
While there are several Medigap plans available (labeled with letters), Plan G has become one of the most popular choices for new Medicare beneficiaries because it offers comprehensive coverage at competitive rates.
Plan G Highlights
- Covers all Medicare Part B excess charges
- No network restrictions - see any doctor who accepts Medicare
- Predictable costs - only pay your Part B deductible and monthly premium
When Can You Enroll?
The best time to buy a Medigap policy is during your Medigap Open Enrollment Period. This 6-month period begins the first day of the month you're 65 or older and enrolled in Medicare Part B. During this time, you have guaranteed issue rights, meaning insurance companies cannot deny you coverage or charge you more due to pre-existing conditions.
Important Note
Waiting to enroll outside of this period may result in higher premiums or coverage denials based on your health history.
Is Medigap Right for You?
Medigap coverage is ideal if you:
- Want predictable healthcare costs with minimal out-of-pocket expenses
- Travel frequently and want coverage anywhere in the U.S.
- Prefer flexibility to see any doctor who accepts Medicare
- Have ongoing health needs and want comprehensive coverage
Get Expert Medigap Guidance
Choosing the right Medigap plan requires understanding your healthcare needs, budget, and future plans. Our team provides independent, expert guidance to help you make the best decision.