A Medigap policy, also known as a Medicare supplement, is designed to supplement the medical coverage provided through the Medicare program. Since Medigap policies vary greatly in cost and coverage, it’s important to find a policy that meets your specific needs.
Do I Need a Medigap Policy? The first thing to ask yourself is whether you need a Medigap policy to fill gaps left by Medicare Part A and Part B. Medigap can help cover coinsurance, copayments, deductibles, and some services not paid by Medicare.
For more on how Medigap works and how claims are handled, see Understanding Medigap Policies and Insurance Claims.
What Are the Medigap Options? There are standardized Medigap plans labeled A through N, each providing a specific set of benefits, so it’s important to match a plan’s features to your current and anticipated needs.
Plans labeled A through G typically offer more extensive coverage and benefits than K and L, but they generally cost more. Also note that newly purchased Medigap policies cannot include prescription drug coverage, so most people who need drug coverage enroll in a standalone Part D plan.
Medigap Pricing Factors
- Some carriers offer discounts, such as for non-smokers or for group memberships.
- Policies sold as Medicare SELECT may require use of certain hospitals or providers for full benefits, which can affect price.
- Some standardized plans, like Plan F, have a high-deductible option that lowers premiums in exchange for a higher out-of-pocket deductible.
- Carriers may use attained-age, issue-age, or community rating to set premiums, which affects how rates change over time.
- Underwriting can affect price unless you apply during your Medigap open enrollment period or a guaranteed-issue window set by state or federal rules.
The best way to find the right Medigap policy at a good price is to comparison shop and make sure you compare the same plan letter across carriers. Your state insurance department or a local resource can help you identify what carriers offer in your area; see Medicare Supplement and Disability/Individual Health Insurance for more carrier information.
If you want personalized help reviewing options, talk to an agent.
Frequently Asked Questions
What does Medigap cover that Medicare does not?
Medigap helps pay some costs that Original Medicare doesn’t cover, such as copayments, coinsurance, and deductibles, depending on the plan letter you choose.
Can I buy a Medigap policy that includes prescription drug coverage?
No, newly sold Medigap policies cannot include prescription drug coverage; most people who need drug coverage enroll in a separate Medicare Part D plan.
When can I buy Medigap without medical underwriting?
You typically have a six-month Medigap open enrollment period starting the month you turn 65 and enroll in Part B, and you may have guaranteed-issue rights in certain other situations specified by law.