What are Medigap Plans? (Medicare Supplement)

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Medigap plans are commonly referred to as Medicare gap plans or Medicare Supplements.

They fill in the gaps of coverage that Traditional Medicare leaves up to the beneficiary to pay. You must have Medicare Part A and Part B to be eligible.

When Medicare covers the costs approved for a medical procedure, your supplement policy will take care of the remaining out of pocket costs.

Coverage is based on the level of coverage that you chose.

Medicare only covers 80% of your medical services, that leaves the remaining 20% up to the recipient to pay.

The information below will discuss eligibility, when to enroll, important information to know, premium rating guidelines, where to find additional resources and where to compare Medigap rates online.

Medigap Plans Eligibility Information

You become eligible for all Medigap plans when you turn 65 years old and are enrolled in Medicare Part B.

Another way to qualify for Medigap insurance is to be on disability for 24 months, but not all states have plans available for these individuals.

The rules are state specific, and the available plans and guidelines vary.

When Can I Apply for Medigap Insurance

Every Medicare recipient is given a time frame to enroll in a supplement plan.

During this time frame a carrier can’t deny you coverage. Nor can they increase your rates due to your current health status. You’re granted Medicare Supplement guaranteed issue rights.

This time frame is called your Open Enrollment Period. This time frame begins the first day of the month your at least 65 years of age and your Medicare Part B has come into effect. Your OEP will be in effect for a total of six months.

After this six month period you can still enroll, but a carrier is allowed to require medical underwriting prior to being approved.

Enrollment Guidelines for Medigap Plans

  • You must have Medicare Part A and Part B.
  • There are 10 standardized Medigap plans lettered A thru N
  • You can go to any doctors or hospital who excepts Medicare not matter what plan or carrier you decide to enroll with.
  • If you have a Medicare Advantage (Part C) plan, make sure you disenroll before your Medigap insurance policy begins.
  • You pay your provider a monthly premium in addition to the monthly Part B premium that you pay to Medicare.
  • A policy only covers one person. If you and your spouse both want Medigap insurance coverage, you’ll each have to buy separate policies.
  • You can buy a policy from any insurance company that’s licensed in your state to sell one.
  • Any standardized policy is guaranteed renewable even if you have health problems. This means the insurance company can’t cancel your policy as long as you pay the premium.
  • Some Medigap policies sold in the past cover prescription drugs, but policies sold after January 1, 2006 aren’t allowed to include drug coverage. If you want prescription coverage, you can join a Medicare Prescription Drug Plan (Part D).
  • It’s illegal for anyone to sell you any Medigap policies if you have a Medicare Medical Savings Account (MSA) Plan.

Medigap Policies Premium Guidelines

Carriers price the premiums for each letter plan off of several factors including age, location, gender, etc. They’re are three types of Medigap pricing guidelines:

  1. Community Rated – the premium is based on your age and could go up due to inflation but never because of your age
  2. Issue Age Rated – the premiums are lower when you enroll at a younger age and won’t increase as you get older
  3. Attained Age Rated – these premiums are low for younger enrollees, however, they can increase as you get older. At the time of purchase this may be the cheapest option, but will eventually catch up to the rates of the above rating methods.

Resources to Learn More

At MedicareFAQ, our goal is to be your main resource center. We provide a large selection of frequently asked questions as well at recent healthcare news and tips on our blog.

Our agents learning videos provide useful information regarding all the different policy options.

Compare Medigap Plans Online

We know your time is limited, that’s why we created forms to get Medigap quotes online.

To compare Medigap insurance rates online, click here. If you prefer to speak to a Medigap agent directly, please dial the number above.

Their standing by to help you find the best Medigap policies for your individual healthcare needs.