Medicare Supplements & Medigap Policies

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Medicare Supplements & Medigap Policies

Medicare is a health insurance program administered by the federal government for people 65 and older, some disabled people under 65, and people with Lou Gehrig’s disease or end-stage renal disease. However, Medicare has several gaps and doesn't pay for all of the health care services that may be required. Medicare supplement insurance is used to help cover some of the charges that Medicare doesn’t pay. Medicare supplement insurance, sometimes referred to as Medigap Insurance, comes in 12 plans labeled “A” through “L” with each plan offering a diverse combination of benefits. A high-deductible option is offered in four plans: F, J, K, and L. However, some carriers may only offer a select number of plans within the twelve.

Medigap policies are not necessary for all Medicare eligible individuals. For instance, if certain types of health coverage are secured, the gaps in Medicare may already be covered. Most likely, Medicare supplement insurance would not be necessary if:

Medicaid or the Qualified Medicare Beneficiary (QMB) Program pays Medicare premiums and other out-of-pocket costs.

An individual belongs to a Medicare Advantage plan

An individual is covered by group health insurance through an employer or former employer including government or military retiree plans

Medigap (Supplemental Insurance) Policies

A Medigap policy is health insurance sold by private insurance companies to fill the “gaps” in Original Medicare Plan coverage. Medigap policies help pay some of the health care costs that the Original Medicare Plan doesn’t cover. If you are in the Original Medicare Plan and have a Medigap policy, then Medicare and your Medigap policy will pay both their shares of covered health care costs.

Insurance companies can only sell you a “standardized” Medigap policy. These Medigap policies must all have specific benefits so you can compare them easily.

You may be able to choose up to 12 different standardized Medigap policies (Medigap Plans A through L). Medigap policies must follow Federal and State laws. These laws protect you. A Medigap policy must be clearly identified on the cover as “Medicare Supplement Insurance.” Each plan, A through L, has a different set of basic and extra benefits.

It’s important to compare Medigap policies because costs can vary. The benefits in any Medigap Plan A through L are the same for any insurance company. Each insurance company decides which Medigap policies it wants to sell.

Generally, when you buy a Medigap policy you must have Medicare Part A and Part B. You will have to pay the monthly Medicare Part B premium. In addition, you will have to pay a premium to the Medigap insurance company.

You and your spouse must each buy separate Medigap policies. Your Medigap policy won’t cover any health care costs for your spouse. (Source: Medicare.gov)

The official government handbooks on Medicare:

Medicare & You 2010 2010 Choosing a Medigap Policy

VIDEO: Stop / Play Medicare & the Affordable Care Act in 2011

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