What is Medigap?

Medigap is an insurance program that is designed to supplement the Original Medicare program. Medigap is sold by private health companies and is designed to help with costs which are not covered by Original Medicare, such as deductibles and co-payments. Certain Medigap policies will also offer additional services such as cover if you are travelling outside of the United States. It is important to note that Medigap is different from a Medicare Advantage Plan as an Advantage Plan is just a way to get Medicare benefits. There are a number of important points to take into consideration if you are thinking about taking on a Medigap plan.

Medigap: Some Facts

  • You can only receive Medigap if you are in receipt of Medicare Parts A and B.
  • If you are already part of a Medicare Advantage plan, you must ensure that you leave it before the Medigap policy comes into effect.
  • You will pay a monthly premium to a private health insurance company for your Medigap policy, on top of the premium you pay to Medicare for your Part B policy.
  • Medigap policies are issued on an individual basis: unlike family health insurance plans, each person must have separate policies for coverage.
  • Any insurance company licensed within your state can provide you with Medigap cover.
  • Medigap is guaranteed renewable; as long as you keep paying the premium your insurance company can’t cancel your policy.
  • Since January 2006 Medigap policies will not cover prescription drugs. You will need to set up a Medicare Part D policy to cover this.
  • If you have a Medicare Medical Savings Account (MMSA) plan, it is illegal for an insurance company to sell you a Medigap policy.
  • A Medigap policy won’t cover everything; generally dental, vision, long-term care and hearing aids aren’t covered. Also eyeglasses and private-duty nursing probably won’t be covered either.