Medicare Supplement plans which are also known as Medigap cover what Original Medicare does not. It is a Medicare insurance product offered by private insurance companies and meant to cover the 20% gap in your healthcare cost including copayments, Part A and B deductibles, and coinsurance. Some Medicare Supplement plans offer additional coverage beyond what Medicare offers, such as fitness membership, worldwide travel emergency, hearing aids, and vision.
Essential things to know about Medicare Supplement (Medigap)
- You must be enrolled in Medicare Part A and B (Original Medicare) in order to qualify.
- Medicare Supplement monthly premium may increase every year. You must continue paying for Medicare Part B monthly premium in addition to Medicare Supplement monthly premium.
- Medicare Supplement doesn’t include Medicare Part D (Prescription Drug). You will need to enroll in Part D even if you don’t take prescription drugs. Failure to do so will result in Part D late enrollment penalties.
- You cannot have a Medicare Supplement plan and a Medicare Advantage plan at the same time.
- Once you are enrolled in a Medicare Supplement plan, the health insurance company cannot terminate your plan as long as you continue paying your monthly premiums.
- Medicare Supplement (Medigap) plans A, B, C, or D are not the same as Medicare Parts A, B, C, and D.
- Medicare Supplement (Medigap) has no network; it gives you freedom to choose any provider in the US that accepts Medicare assignment. It doesn’t matter what company you purchased your Medicare Supplement plan from, you don’t need to worry if the provider is in that plan’s network. As long as the provider takes Medicare, you can see them and be covered by your Medicare Supplement plan.
Frequently Asked Questions
After your visit or procedure, your provider sends the bill to Medicare, then your Medigap plan covers out-of-pocket costs that you are responsible for after Medicare has paid their portion of your medical costs. You could have low to zero out-of-pocket costs, depending on what letter Medigap plan you choose.
Once you enroll in Medicare Part B, you will have a six-month window to enroll in Medigap insurance without having to answer health questions and go through medical underwriting. Once this window has passed, you can still enroll in a Medigap plan anytime, but you must pass medical underwriting.
- Medicare Advantage PPO comes with a limited network of providers. You will still have an option to see out-of-network providers, however you will pay higher coinsurance. Medicare Supplement (Medigap) has no network; it gives you freedom to choose any provider in the US that accepts Medicare assignment.
- Unlike Medicare Advantage PPO, most Medicare Supplement plans don’t have copayments or coinsurance. However the Medicare Supplement monthly premium is generally higher than Medicare Advantage PPO.
- Most Medicare Advantage PPO plans do include Medicare Part D (Prescription Drug), while Medicare Supplement plans don’t.
No, they are not the same. You leave Original Medicare when you sign up for Part C, while Medigap/Medicare Supplement plans work with Original Medicare to provide you more comprehensive benefits than Original Medicare has to offer.