What is Medigap Heath Insurance Coverage


While Medicare supplies a lot of insurance coverage for individuals, it doesn’t cover everything. If you have Medicare insurance but need additional coverage, you want to consider investing in an additional policy to provide coverage where your Medicare falls short.

What is Medigap Insurance Coverage

Medigap insurance is also known as a Medicare Supplement. You can purchase this type of insurance from a private insurance company but understanding a few of the specifics will help you make a more informed choice regarding your insurance coverage. Your policy can be used to cover expenses that you incur under Medicare like co-pays and deductibles.

What You Need to Know About Medigap Coverage

As with any insurance plan, you’re required to abide by certain “rules” to qualify for and maintain coverage with this type of policy. You’ll need to:

  1. Have Medicare Part A and Part B coverage.
  2. Discontinue coverage with a Medicare Advantage Plan before your policy begins.
  3. Pay both the monthly premium on your policy and your Part B Medicare coverage.
  4. Take out separate policies if you need to have coverage for yourself and your spouse.
  5. Purchase your policy through an insurance company licensed to sell in your state.
  6. Maintain coverage by keeping your premium current.
  7. Understand that policies originating after June 1st, 2010 don’t incorporate coverage for prescription medication. If you require this type of coverage, you’ll need to add a Medicare Prescription Drug Plan.

What’s Not Covered by Medigap

Medigap is supplemental insurance coverage, so it doesn’t cover everything. In most cases, it doesn’t cover long term care, dental or vision provision, hearing aids, glasses or lenses, or private nursing.

What Other Medicare Plans Can’t be Used with Medigap

There are several different plans that don’t qualify, some of these include:

  • Medicare Advantage Plans, such as a PPO, HMO, or other similar plans
  • Medicaid
  • Employer-provided or union plans
  • Veterans’ benefits
  • Longstanding care insurance policies

Is it Possible to Drop a Policy

It’s possible to drop a policy; however, you’ll need to keep in mind the following:

  • When you first turn 65 and enrolled into Medicare Part B, you’re in your Open Enrollment Period (OEP). During this time, you can’t be denied coverage nor charged more for pre-existing conditions.
  • Outside of your OEP you must medically qualify. So, make sure if you drop a plan that you enroll in another prior to terminating your original policy.
  • You can drop a policy anytime throughout the year, but if you can’t qualify for another policy, you may be stuck with just Original Medicare.

What is the Cost of Medigap Coverage

While premiums for this type of coverage vary by insurance company, the benefits of each standard plan are always the same. For example, a Medigap Plan G offers set benefits no matter which company you purchase it from.

A qualified representative can help you compare plans and prices to help you get the best coverage within your budget. The cost depends on many different factors that are specific to you.

Medigap Open Enrollment Period

Your Medigap Open Enrollment Period starts the first day of the month after your 65th birthday and Medicare Part B effective date. During this period of time, you can purchase any policy at the same price as an individual who is in good health pays.

If you decide to invest in a policy outside of this time frame, there’s no guarantee that you’ll be able to secure coverage. And if you’re able to get coverage, you’ll likely pay a higher rate.

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