If you've chosen the path of Original Medicare (Part A and Part B), you have fantastic, flexible coverage that lets you see any doctor in the country who accepts Medicare.
However, as many soon discover, Original Medicare doesn't cover 100% of the costs. You are still responsible for things like deductibles, copayments, and a 20% coinsurance on most medical services. These out-of-pocket costs are often called the "gaps" in Medicare.
This can be a major source of anxiety. How do you protect yourself from these unpredictable expenses? The answer is often a Medicare Supplement Insurance policy, more commonly known as Medigap.
What Exactly is Medigap?
Think of Medigap as a financial safety net. It's an extra insurance policy you can buy from a private company that works with your Original Medicare. Its sole purpose is to help pay for some of the remaining healthcare costs that Medicare doesn't cover, like your coinsurance and deductibles.
By "filling the gaps," a Medigap policy gives you more predictable healthcare costs and protects your savings from unexpected medical bills.
What Does Medigap Typically Cover?
Medigap policies are standardized and labeled with letters (like Plan G or Plan N). While the specific benefits vary by plan, they are designed to help pay for things like:
- Part A hospital coinsurance and hospital costs
- Part B coinsurance or copayments
- The Part A hospice care coinsurance
- The Part A deductible
- Skilled nursing facility care coinsurance
It's important to know that Medigap policies generally don't cover prescription drugs. For that, you would still need a separate Part D Prescription Drug Plan.
How Does Medigap Work?
There are two key things to understand about how Medigap works:
- It only works with Original Medicare. You cannot have a Medigap policy and a Medicare Advantage Plan at the same time.
- The plans are standardized. This is a huge benefit for you. It means that a "Plan G" from one insurance company has the exact same basic benefits as a "Plan G" from another company. The only difference is the price and the company's reputation for service.
The best time to buy a Medigap policy is during your 6-month Medigap Open Enrollment Period, which automatically starts the month you're 65 or older and enrolled in Part B. During this time, you have a guaranteed right to buy any policy, regardless of your health status.
Finding the Right Safety Net for You
With different lettered plans and multiple companies offering them, choosing the right Medigap policy can feel like another complicated puzzle. But it doesn't have to be.
As your independent agent, my role is to help you find the perfect balance. We'll analyze your specific needs and budget to determine which Medigap plan letter is the right fit. Then, we can compare prices from reputable carriers to ensure you're getting the best possible value.
Ready to build your financial safety net and enjoy the peace of mind that comes with truly comprehensive coverage? Schedule your free, no-obligation 15-minute consultation today.
About the Author:
Gwen Morris is a licensed and annually certified health insurance agent with over 17 years of insider experience in the healthcare system. As the founder of Easy Coverage Solutions, she is dedicated to providing clear, empathetic, and tailor-made Medicare guidance to seniors and their families in New Jersey, Pennsylvania, and Tennessee.