What is a Medigap Policy & What Does it Cover?

Many seniors are unaware that their Traditional Medicare only covers a portion of their medical bills. There are many out of pocket costs left up the beneficiary to pay including coinsurance, copayments and deductibles. Below will discuss what a Medigap policy is, what it costs, what it covers and when to apply.

What is a Medigap Policy?

A Medigap policy is supplemental health insurance that caters to your healthcare costs that are not covered by primary Medicare. Such costs include co-payments, deductibles, and treatment outside the U.S. 

What is the Cost of a Medigap Policy?

Once you have enrolled in a plan, you will be required to pay the monthly premium to your insurer on top of your Medicare Part B premium. The cost of a Medigap policies monthly premium depends on the insurance company, the type of plan you purchase, your age, and your location. Paying your premiums on time guarantees you the renewal of your policy, even if you have a health-related problem.

what is a medigap policy

However, you may be forced to wait up to a period of six months for coverage, in the case of a pre-existing health condition. Your insurer may refuse to pay for your out-of-pocket costs for pre-existing health problems during that time. 

The policy must cover pre-existing conditions after six months. The exception to this rule is if you bought the policy during your Open Enrollment Period or if you had continuous “creditable insurance” for the six months prior to buying a policy. 

Remember, insurers set their own monthly premiums and underwriting qualifications, so, it pays to shop around. The cost varies depending on your location, your health condition and, of course, the particular plan you choose. Fill out the rate form on our site and we’ll compare different rates from various top insurance companies. Remember that if you want to get coverage as a couple, you will have to purchase separate policies; spouses cannot be covered together.

When is the Best Time to Apply?

The best time to apply for a Medigap policy is during your six month Open Enrollment Period. During this period, you’re allowed to purchase any policy available in your state, whether you have a pre-existing health condition or not and at the same price as someone in good health. This period automatically starts on the first day of the month after your 65th birthday AND you must already be enrolled in Medicare Part B.

What Does a Medigap Policy Cover?

There are ten supplemental policies that you can choose from, with names running from A through N. Each Medigap policy covers different benefits and has a different premium. Medicare Supplement Plan A provides the core or basic benefits. 

The other nine provide the primary benefits together with one or more other advantages. For instance, Medicare Supplement Plan F will provide something that is missing in Medicare Supplement Plan C but will lack a benefit found in Medicare Plan G.

There is no distinction in plans as offered by different insurance companies; policy details are all determined by the state government. Beneficiaries should carefully review the different policy packages and decide which coverage is appropriate for them.

What is the Best Medigap Policy?

The best Medigap policy is different for every Medicare beneficiary. It depends on your health history, your current health status and your finances. The best policy for one person may not be the best policy for you. The best way to know more about these plans and which one best suits your needs is by contacting our team of Medicare agents, who will help to match a plan to your specific needs.

Remember, some policies provide higher monthly premiums but less out of pocket expenses, while some provide lower monthly premiums but high out of pocket expenses. 

Where to Sign Up for a Medigap Policy

We know finding a plan that best fits your individual healthcare needs can be confusing, that’s why we provide answers to the most frequently asked questions here. At no additional cost, we’ll compare rates with all the top carries in your area! We know you’re time is valuable, so we provide two ways to sign up for a Medigap policy:
  1. If you prefer to speak to a senior Medicare agent directly, please call us at the number above to be connected with a licensed agent in your area. 
  2. Complete our online rate form to have an agent start comparing rates for you based off your individual healthcare needs.

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