Guide to Medigap Policies

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Medigap policies are health insurance policies sold by private insurance companies. If you have a Medigap policy, Original Medicare first pays its share for your care, and then Medigap pays all or part of the remaining costs, including deductibles, coinsurance and copayments. Medigaps may also cover some health care that Medicare doesn’t cover at all. Medigaps only work with Original Medicare; not Medicare Advantage plans.

Before you buy a Medigap, be sure to do your research. Use the web pages in this section of Medicare Interactive as a guide to help you understand Medigaps and to find the best option for you. Some pages you may want to visit are linked below. 

  1. Make sure you need a Medigap. Remember that you only need a Medigap if you want to keep Original Medicare. If you want to enroll in a Medicare Advantage plan, Medigaps do not apply to you.
  2. Learn when you have the right to buy a Medigap so you can time your enrollment wisely. In most states, you have a limited window of time to buy a Medigap policy if you are age 65 or older. If you are under age 65, your ability to enroll in a Medigap is typically more limited. 
  3. Once you decide you need a Medigap and you are able to enroll into a Medigap, compare the different types of policies that exist. There are 10 different standardized policies and you need to select the best one for you.
  4. Learn how a Medigap should cover prior medical conditions to know if any of your medical costs may be excluded. Depending upon your circumstances, a Medigap can exclude coverage for prior medical conditions for a limited amount of time.
  5. Find out how Medigap premiums are priced so you can make adequate cost comparisons.  It’s important to understand the ways that insurers set premiums to find the best deal for you.
  6. Have a list of questions to ask when you shop for a Medigap to remind you what you should consider.  Buying a Medigap can be a confusing experience. Rely on written questions can help you stay organized and simplify the process.

If you are confused about Medigaps, how to enroll, or what policy is best for you, contact your State Health Insurance Assistance Program (SHIP). You can find the number for your SHIP by visiting http://shiptalk.org. For additional information on Medigap policies in your state, you can also contact your State Department of Insurance.


Related Questions
Can my state give me more rights and protections than federal law regarding Medigap plan enrollment?

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How Medigap Policies Cover Prior Medical Conditions

Medigap Costs in New York State

Medigap Enrollment in New York State

 
LINKS
Medicare.gov Medigap (Medicare Supplement) Policies & Guide

State Insurance Department Websites

State Health Insurance Assistance Program (SHIP) Directory

 
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