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Medigap: What Does it Cover?

| November 13, 2020
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As you determine what the right Medicare plan options are for you, it’s important to be sure you have the coverage essential for your health care and retirement needs. On average, Original Medicare only covers about 80% of medical costs. It’s for this reason that some individuals choose to purchase Medicare Supplement Insurance Policies, known as Medigap.

Medigap policies are add-on policies only available to those with Original Medicare and are offered by private insurance companies to fill in gaps where Plans A & B leave off. Medigap can help with expenses such as deductibles, co-payments, or health care if you plan to travel outside the US. Here are some things to know regarding Medigap:

How Medigap Works - Like a typical insurance policy, Medigap is acquired by paying a monthly premium. Medigap plans are delineated by letter from A to N and premiums vary by carrier, but the benefits of specific Medigap plans are standard across the board. So, for example, Medigap Plan B will offer the same benefits no matter which company you choose to purchase it from.

Enrollment Period - The open enrollment period for purchasing a Medigap plan is six months from the first day of the month of the your 65th birthday. You must be signed up for Medicare Part B before you can purchase Medigap. If you try to purchase outside this window, you could face higher rates or be ineligible altogether. Each insurance company will have its own rules and policies about enrollment, so it’s prudent to shop around before committing.

Coverage Options - Typically, Medigap plans are used to assist in paying Medicare deductibles, co-payments, co-insurance, and other services not covered by Medicare Parts A & B. More expensive plans may offer additional benefits such as prescription drug coverage, additional hospital benefits, or intermittent in-home health care.

If you’d like to discuss whether or not adding a Medigap policy makes financial sense for you, don’t hesitate to reach out. We’d be happy to discuss your options to ensure you have the right health care plan that factors into your retirement goals.


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