What is a Medicare Supplement? What is Medigap Insurance?
Medigap is Medicare Supplement Insurance that helps to fill “gaps” in Original Medicare. It is sold by private companies, and Original Medicare pays for much, but not all, of the cost for covered health care services and supplies.
A Medicare Supplement Insurance/Medigap policy can help pay some of the remaining health care costs, like:
- Deductibles – ex. Part A/Hospital Deductible.
- Copayments – ex. Emergency Room and Medical Doctor Copays.
- Coinsurance – ex. Part B 20% Coinsurance.
- Excess Charges – ex. Part B Excess Charges.
Medicare Supplement/Medigap policies impose no hospital or medical network restrictions and do not replace Medicare.
Instead, Medicare Supplements work alongside Original Medicare and pay the cost that remains after Original Medicare has paid, in accordance with the plan documents. If you have Original Medicare and you buy a Medicare Supplement/Medigap policy:
- Medicare will pay its share of the Medicare-approved amount for covered health care costs.
- Then, your Medigap policy pays its share.
- When you seek medical care, present your Original Medicare card and your Medicare Supplement/Medigap card.
- The facility or doctor’s office will bill Medicare first. Then Medicare will pay its share and send the rest of the bill to your Medicare Supplement/Medigap company.
What a Medicare Supplement
will NOT cover.
Medicare Supplement/Medigap policies generally do not cover long-term care, vision, dental, hearing aids, eyeglasses, or private-duty nursing. Some Medigap policies do cover services that Original Medicare does not cover, like medical care when you travel outside the U.S. Medigap plans also pay your Part A coinsurance up to an additional 365 days after Medicare benefits are used up.
Medicare Supplement/Medigap policy premiums vary depending on age and gender. During the Medigap Open Enrollment Period (OEP), no underwriting is required. Otherwise, underwriting is mandated, and tobacco use and general health is taken into account. For more information, visit the “Enrollment Periods” section.
