Medicare Supplement (Medigap)

For many Medicare beneficiaries, Original Medicare (Part A and Part B) is the foundation of their health coverage, but it often leaves significant gaps in coverage. While Original Medicare covers about 80% of your medical costs, you are responsible for the remaining 20% in the form of deductibles, copayments, and coinsurance. Over time, these out-of-pocket costs can add up, creating a significant financial burden. This is where a Medicare Supplement Insurance plan, or Medigap, comes in. Medigap policies are designed to fill these “gaps” in Original Medicare, providing a critical layer of financial security.

Unlike Medicare Advantage Plans, Medigap policies work in conjunction with your Original Medicare. This means you must be enrolled in both Medicare Part A and Part B to be eligible. The primary purpose of a Medigap plan is to help pay for the out-of-pocket expenses that Original Medicare doesn’t cover. These can include Part A and Part B coinsurance, deductibles, and in some cases, even foreign travel emergency care. A key benefit of Medigap is the incredible flexibility and freedom to choose your providers. If a doctor or hospital accepts Original Medicare, they must accept your Medigap plan, regardless of the insurance company you purchased it from. This means you can see any specialist or doctor in the country who takes Medicare, without the need for referrals or concern about network restrictions.

Medigap plans are standardized by the federal government, with different plans identified by letters (A, B, C, D, F, G, K, L, M, and N). The benefits of a Plan G, for example, are the same no matter which insurance company sells it. This standardization makes comparing plans much easier, as you are simply comparing prices between different carriers for the exact same coverage. This transparency allows us to find you the most competitive rate for the plan that best suits your needs. However, it’s important to note that Medigap policies do not include prescription drug coverage or other additional benefits like dental, vision, or hearing care. If you choose a Medigap plan, you will need to purchase a separate Medicare Part D (prescription drug) plan to cover your medications. We will help you select a standalone Part D plan that covers your specific prescriptions and provides the best value.

The best time to enroll in a Medigap plan is during your six-month Medigap Open Enrollment Period, which begins the month you turn 65 and are enrolled in Part B. During this period, insurance companies cannot deny you a policy or charge you more based on your health status. After this period, you may be subject to medical underwriting, which can result in higher premiums or even a denial of coverage if you have pre-existing health conditions. We will help you understand this crucial enrollment window and ensure you take advantage of it to lock in the best possible rate. Our comprehensive approach to Medigap means we will not only help you choose the right plan but also ensure you understand how it works with your Original Medicare and any other plans you choose, providing you with a seamless and worry-free healthcare experience.