MEDIGAP/SUPPLEMENT PLANS

Medigap is extra health insurance that you buy from a private company to pay health care costs not covered by Original Medicare, such as co-payments, deductibles, and health care if you travel outside the U.S. Medigap policies don't cover long-term care, dental care, vision care, hearing aids, eyeglasses, and private-duty nursing. Most plans do not cover prescription drugs. You pay a monthly premium for a Medigap policy.

Standard Medigap plans are labeled A through N and offer different levels of health coverage. Plans E, H, I, and J are no longer available to new subscribers. Soon, additional plans will also no longer be available for sale.

Medigap policies are only available to people who already have Medicare Part A, which helps pay for hospital services, and Medicare Part B, which covers the cost for doctor services. People who have a Medicare Advantage plan cannot get a Medigap plan.

Medigap policies are standardized. Every Medigap policy must follow federal and state laws designed to protect you, and it must be clearly identified as "Medicare Supplement Insurance." Insurance companies can sell you only a "standardized" policy identified in most states by letters. Currently, there are 10 standardized plans to choose from.

Premiums vary among insurance companies, but the benefits of each standard Medigap plan are always the same. For instance, a Medigap Plan C policy offers set benefits no matter which company you buy it from.

 

Again, all policies offer the same basic benefits but some offer additional benefits, so you can choose which one meets your needs. In Massachusetts, Minnesota, and Wisconsin, Medigap policies are standardized in a different way.

Each insurance company decides which Medigap policies it wants to sell, although state laws might affect which ones they offer. Insurance companies that sell Medigap policies:

  • Don't have to offer every Medigap plan

  • Must offer Medigap Plan A if they offer any Medigap policy

  • Must also offer Plan C or Plan F if they offer any plan

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