Getting Started
Medicare Supplement Plans
Medicare Supplement (Medigap) is another coverage option offered by private insurance companies to help fill the gaps left by Original Medicare, including certain out-of-pocket costs like deductibles, copayments, and coinsurance.
Supplement Plans
Medicare Supplement Plans
Gaps in healthcare coverage may mean that some people have trouble gaining coverage in certain situations or end up with high out-of-pocket expenses. Medicare Supplement Plans were designed to help close these gaps. That is why Supplement plans are often called “Medigap” plans.
What separates Medicare Supplement from Medicare Advantage is that Medicare Supplement plans are designed to cover the gaps left by Original Medicare. An easier way to think about Medicare Supplement plans is that they help cover the costs that Original Medicare normally passes on to the patient. This may include deductibles, copayments, and coinsurance.
Medicare will pay its usual share of covered expenses, and then your Medicare Supplement plan may cover its share. In many cases, the Supplement plan pays for the remaining balance of the bill, but this can vary depending on the plan’s design.
However, be aware that Medicare Supplement plans are medical insurance only. Since Medicare Supplement plans work alongside Original Medicare, your provider must accept Original Medicare in order for your Supplement plan to help cover costs.
With a Medicare Supplement plan, you can get nationwide coverage. That’s right—you can use your Medicare Supplement plan anywhere in the country as long as your provider accepts Medicare. The exception is if your situation is considered an emergency, where different rules may apply.
Types of Plans
Types Of Medicare Supplement Plans
Medicare standardized all Supplement plans in 1990, designating each type of plan with a letter. Medicare Supplement plans are named as follows: A, B, C, D, F, G, K, L, M, and N.
No matter which private insurance company provides the policy, plans with the same letter will offer the same benefits. The main difference between Medicare Supplement plans from one insurance company to another is the premium.
The amount of coverage you want your Medicare Supplement plan to provide, along with other factors, will determine your premium. Beneficiaries should shop and compare plans to find the option that best meets their needs and budget.
Here are some items that are generally not covered by Medicare Supplement Plans:
Routine dental, hearing, and vision exams
Glasses or contact lenses
Hearing aids
Retail prescription drugs
Long-term care or custodial care
With Medicare Supplement plans, it is important to remember that if Original Medicare does not cover a service, your Medicare Supplement plan generally will not cover it either. Medicare Supplement plans are designed to help pay for certain costs that Original Medicare approves, such as deductibles, copayments, and coinsurance.
Application
How To Enroll into A
Medicare Supplement Plan
Medicare Supplement plans do not have annual enrollment periods like Medicare Advantage or Part D plans. If you want to enroll in a Medicare Supplement plan, you may need to either have a Guaranteed Issue right or complete medical underwriting, depending on your situation.
Guaranteed Issue means that an insurance company must accept your application without reviewing your health history due to a qualifying life event. If you do not have a Guaranteed Issue right, you may need to go through the underwriting process, where the insurance company reviews your health information before approving coverage.
Your first opportunity for Guaranteed Issue is typically during your Medicare Supplement Open Enrollment Period. The timing of your Medigap Open Enrollment Period is based on when you are 65 or older and your Medicare Part B coverage becomes effective. There are also several other situations that may provide Guaranteed Issue rights. Be sure to discuss your options with a licensed Medicare agent.
Your Medicare Supplement Open Enrollment Period begins when you are enrolled in Medicare Part B and are age 65 or older. This enrollment window lasts for six months and does not repeat.
For many people, this means their Medigap Open Enrollment Period begins when they turn age 65 and their Part B coverage starts. However, if you delay Part B because you are covered by an employer group health plan, your Medigap Open Enrollment Period will begin when your Part B coverage becomes effective.
It is important to speak with a licensed insurance professional as your Open Enrollment Period approaches to understand your rights and options regarding Medicare Supplement plans.
Medicare FAQ's
Got questions? We've got answers
You are eligible to apply for Medicare during your initial enrollment period which is a 7 month window. 3 months before turning 65, the month you turn 65 and 3 months after turning 65.
The easiest way to sign up for Medicare is online through SSA.gov or by Calling Social Security at 1-800-772-1213. You can also visit your local Social Security Office.
If you are already receiving Social Security Benefits you will be automatically enrolled into Original Medicare, otherwise you will be eligible to enroll during your initial enrollment period that starts 3 months before your 65th birthday.
If you miss your Initial Enrollment Period you can sign up during the General Enrollment period that occurs every year January 1st through March 31st. Coverage becomes effective the month following your enrollment date.
Yes, there are penalties for not signing up for Part B of Medicare and will be added to your premium.
If you need a new Medicare card you can order a replacement card by phone at 1-800-772-1213, or online at the Social Security Administration web site. Make sure you have your Medicare number ready when you call.