Exploring Medigap: Enhancing Your Medicare Coverage

Posted by Peggy Tomasello
Estimated Reading Time 2 minutes 1 second

After enrolling in Medicare Parts A and B, you might find that additional coverage through a Medicare Supplement Insurance plan, or Medigap can be beneficial. Medigap helps to minimize your out-of-pocket expenses for services covered under Medicare.

What Are Medicare Supplement Plans?

Medicare Supplement Insurance plans, provided by private insurers, are designed to complement Original Medicare by covering a portion of the out-of-pocket costs such as deductibles, copayments, and coinsurance. With many different Medigap plans available, each offering unique benefits, these plans are vital for reducing unpredictable medical expenses.

When you purchase a Medigap policy, you’ll pay a monthly premium to the insurer in addition to your Part B (and possibly Part A) premiums. Note that Medigap cannot be used with Medicare Advantage plans (Part C); it is exclusively for Original Medicare.

Optimal Timing for Enrolling in Medigap

The ideal time to enroll in a Medigap plan is during the six-month Open Enrollment Period that begins when you first sign up for Medicare Part B. During this window, insurers cannot deny coverage or charge higher rates based on your health status. Enrolling during this period ensures access to the best prices and plan options.

Delaying Medigap enrollment beyond this period can result in higher premiums or even coverage denial, so timely enrollment is crucial.

Understanding Medigap Plans

There are ten standardized Medigap plans, labeled A through N, each offering a different level of coverage. While the basic benefits are consistent across plans of the same letter regardless of the insurer, some states may have variations, so check local specifics.

Common benefits include:

• Coverage for hospital coinsurance and costs up to an additional 365 days
• Full or partial coverage of Part B coinsurance or copayments
• Full or partial coverage for the first three pints of blood annually
• Full or partial coverage for hospice care coinsurance or copayments

Some plans also cover additional costs like Part A and B deductibles, skilled nursing facility coinsurance, Part B excess charges, and foreign travel emergency costs.

The Most Popular Medigap Plans

• Plan A: Covers essential benefits at the lowest cost.
• Plan F: Offers comprehensive coverage, but is only available to those enrolled in Medicare before January 1, 2020.
• Plan G: Similar to Plan F but does not cover the Part B deductible.
• Plan N: Similar to Plan G, but does not cover the Part B deductible and excess charges.
• Choosing the Right Medigap Plan

When selecting a Medigap plan, consider both your current and future healthcare needs. Compare the benefits and costs of similar plans (like Plans F and G) from different insurers to find the best value.

Ready to Enroll?

If you’re new to Medicare or considering changing your coverage, now is the time to explore your options to protect yourself from high out-of-pocket costs. An experienced Licensed insurance agent can help you identify a Medigap plan that aligns with your health needs and budget.