Guide to Medicare Supplement Insurance - (Medigap)

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If you know anything about Original Medicare Part A and Part B, you'll know that it pays about 80% of any medical expenses that are approved by Medicare. The other 20% is your responsibility, and in order to limit your financial exposure, you'll have the opportunity to purchase a Medigap Insurance policy. 

There are many insurance companies that offer Medicare Supplemental Insurance policies and because the benefits are standardized by the government, it makes it a little easier finding an insurance carrier that offers the plan you want at a competitive price. There are some other considerations when picking an insurance company for Medigap, like financial stability and how long they have been in the market with Medigap policy offerings. 

In addition, these private insurance companies can choose a method of determining premiums. In some cases State law will determine what premium method is used to determine premiums for policyholders. 

What are the benefits of having a Medicare Supplement (Medigap) plan.

The short answer is that Medicare Supplement insurance provides financial security in the event that you need medical treatment from doctors, hospitals and surgeries etc. There are different Medigap policy types, and each plan offered has a specific benefit structure to help pay for the 20% of costs not covered by Original Medicare Part A and Part B. 

There are other benefits of purchasing a Medicare Supplement policy like:

• A predictable monthly premium for budgeting purposes
• The ability to seek treatment from any doctor or hospital across the country that accepts original Medicare
• No pre-authorization required for medical for services
• A guarantee that you will never be dropped or terminated by the insurance company, other than not paying your premiums!

When to enroll in a Medicare Supplement (Medigap) plan.

The Medigap Open Enrollment period last six months from the time you are eligible for Medicare Part B. In most cases this is when you are turning age 65, or later if retiring after age 65. No matter what, you'll not be denied coverage for a Medigap insurance policy during this enrollment period because of a health condition. 

Some states do offer a second opportunity outside of the initial enrollment period for Medigap enrollment. These states either have an anniversary rule or a birthday rule and insures must accept applications regardless of health conditions, otherwise known as Guaranteed Issue. 

What does a Medigap policy cover?

Each Medigap plan has a standard set of benefits, but all Medigap Insurance Policies must cover the following at 100%:

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