Medigap (Medicare Supplement Health Insurance) Coverage: An Expert Guide (2024)
Medicare Supplement Plans (Medigap) are helpful for recipients of Original Medicare Parts A or B. Because Medicare does not cover every healthcare service you may need, Medigap fills in where Medicare falls short. For example, copayments, coinsurance, and deductibles are all covered by Medigap, while services like long-term and dental care are not.
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Daniel Walker
Licensed Insurance Agent
Daniel Walker graduated with a BS in Administrative Management in 2005 and has run his family’s insurance agency, FCI Agency, for over 15 years (BBB A+). He is licensed as an insurance agent to write property and casualty insurance, including home, life, auto, umbrella, and dwelling fire insurance. He’s also been featured on sites like Reviews.com and Safeco. To ensure our content is accura...
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UPDATED: Dec 4, 2023
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Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything insurance related. We update our site regularly, and all content is reviewed by insurance experts.
UPDATED: Dec 4, 2023
It’s all about you. We want to help you make the right coverage choices.
Advertiser Disclosure: We strive to help you make confident insurance decisions. Comparison shopping should be easy. We are not affiliated with any one insurance provider and cannot guarantee quotes from any single provider.
Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different insurance companies please enter your ZIP code on this page to use the free quote tool. The more quotes you compare, the more chances to save.
On This Page
- Medicare Supplement Plans (Medigap) fill in the gaps from Original Medicare Parts A and B coverage
- Humana, Aetna, Cigna, and more are all companies that sell Medicare Supplement Plans (Medigap)
- Medicare Supplement Plans (Medigap) quotes depend on when you buy, your health conditions, and more
At 65 years of age, Medicare federal health insurance becomes available. While a standard Medicare plan, Medicare plans A and B, cover quite a few things, they do not always cover everything you need.
Fortunately, Medicare provides options that fill in where Medicare parts A and B fall short. For example, if your Medicare part A or B plan does not cover you fully, you may choose from one of the ten Medicare Supplement Plans (Medigap) available to you. Keep reading to learn more about Medicare Supplement Plans (Medigap), including what they are, what they cover, when to buy them, and more.
Before learning more about Medicare Supplement Plans (Medigap), enter your ZIP code into our free online tool for instant health insurance rates in your area.
Table of Contents
What are Medicare Supplement Plans (Medigap)?
Fundamentally, Medicare Supplement Plans (Medigap) are health insurance policies designed to complement an original Medicare Part A or B plan. Medigap plans are sold by private insurance companies and cover remaining health care costs from an Original Medicare plan.
The way Medicare Supplement Plans (Medigap) work is simple. Medicare covers its share of pre-approved healthcare costs, and Medigap steps in to cover the rest.
It is also important to outline what Medigap is not. Here’s a quick list of the Medicare and healthcare plans that are often mistaken for Medigap:
- Medicare Advantage Plans (like an HMO, PPO, or Private Fee-for-Service Plan)
- Medicare Prescription Drug Plans
- Medicaid
- Employer or union plans (including the Federal Employees Health Benefits Program)
- Tricare
- Veterans’ benefits
- Long-term care insurance policies
- Indian Health Service, Tribal, and Urban Indian Health plans
Often, Medicare recipients confuse Medigap with Medicare Part C, a Medicare Advantage Plan.
Medicare Advantage Plans are a means of getting additional Medicare benefits like copayments, coinsurance, deductibles, and more. On the other hand, Medicare Supplement Plans (Medigap) only add to your current Medicare benefits.
We recommend discussing your needs and options with your health insurance agent before deciding on a policy. A conversation with your agent will help guide you in the right direction for your needs.
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What do Medicare Supplement Plans (Medigap) cover?
Medicare Supplement Plans cover the cost of additional health care services not covered by your current Medicare plan. Some of the general services Medigap covers include:
- Coinsurance
- Copayments
- Deductibles
Some Medicare Supplement Plans (Medigap) even cover medical care when traveling outside of the United States. It’s best to be familiar with your Original Medicare Plan to know what kind of Supplemental Plan you need.
Health services that Medicare, including Medicare Supplement Plans (Medigap), do not cover include:
- Long-term care
- Vision care
- Dental care
- Hearing aids
- Eyeglasses
- Private-duty nursing
If you need any service not covered by Medicare, you will have to either pay for it out-of-pocket or find another means of getting it.
When do I buy Medicare Supplement Plans (Medigap)?
Medicare Supplement Plans become available to you on the first day of the first month you turn 65 or older and enrolled in Medicare Part B. However, some states allow you to buy a Medigap plan on your first enrollment in Medicare Part B, even if you’re not yet 65.
If you are under 65, you may receive a Medicare Supplement Plan if you have a disability or an end-stage renal disease. Once you are of age to receive a Medicare Supplement Plan, there are a couple of additional requirements you must first fulfill:
- Must be enrolled in Medicare Parts A & B
- You must live in the state where the policy is offered
Again, make sure to discuss all of your options with a healthcare professional before you decide on a Medicare plan.
How do I buy Medicare Supplement Plans (Medigap)?
You can start your search for Medicare Supplement insurance companies through Medicare’s official website. You can find a complete list of Medicare Supplement Plans and their unique benefits.
Once you decide on a plan, you search for healthcare companies that sell Medigap plans using the website’s search tool. Doing so will instantly pull up companies and policies near you.
When you have narrowed down your options to at least three, contact the insurance companies of your choice for Medicare Supplement Plans (Medigap) quotes. Having at least three quotes will allow you to choose the best company and policy for your needs.
Note that each insurance company sets its price for its policies. So a quote you get for a policy from one company could be completely different from a similar policy with a different company. In addition, Medicare Supplement Plans (Medigap) rates can change based on when you buy, your health conditions, and more.
Most generally, however, Medicare Supplement Plans (Medigap) are priced, or “rated,” in three ways:
- Community-rated (“no age-rated” ): not based on age, prices vary due to inflation or other factors apart from age
- Issue-age-rated (“entry age-rated” ): age you are when you buy the Medigap policy
- Attained-age-rated: your current age
Again, regardless of how the Medigap plan is rated, the quotes you get may vary depending on the insurance company. A few of the top 10 Medicare Supplement Insurance companies include:
- Humana
- AARP
- Aetna
- Cigna
- Mutual of Omaha
AARP Medicare Supplement Plans are sold through UnitedHealthcare, and provide guaranteed coverage for life, coverage when you travel, and more. For more details on these and more reputable health insurance companies, look at our company reviews, including Aetna Final Expense Review and more.
As always, you must make sure to compare multiple insurance companies and their quotes before deciding.
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Case Studies: Medigap (Medicare Supplement Health Insurance) Coverage
Case Study 1: Secure Shield Insurance Company
Mrs. Anderson, a 68-year-old retiree, enrolled in Original Medicare when she turned 65. A few months later, she experienced a health crisis requiring hospitalization. While Medicare covered most of her hospital expenses, she was left with significant out-of-pocket costs, including deductibles and coinsurance.
However, having purchased a Medigap policy from Secure Shield Insurance Company, Mrs. Anderson had additional coverage that helped her pay for these expenses. Thanks to her Medigap plan, she was able to focus on her recovery without worrying about financial burdens.
Case Study 2: PrimeCare Health Insurance
Mr. Thompson, a 72-year-old Medicare beneficiary, was diagnosed with a chronic condition that required frequent doctor visits and prescription medications. As a retiree on a fixed income, he was concerned about the potential cost of his healthcare needs. Fortunately, Mr. Thompson had enrolled in a comprehensive Medigap plan offered by PrimeCare Health Insurance.
This plan covered his out-of-pocket costs, such as copayments and deductibles, ensuring he could afford the necessary treatments and medications. With PrimeCare’s Medigap coverage, Mr. Thompson gained peace of mind and better access to the care he needed.
Case Study 3: TrustedCare Insurance Corporation
Mrs. Ramirez, a 67-year-old Medicare beneficiary, relied on various healthcare services due to her pre-existing conditions. She often sought specialized care and had to travel out of state to receive treatment. Recognizing the potential financial strain of these frequent visits, Mrs. Ramirez purchased a Medigap policy from TrustedCare Insurance Corporation.
This plan provided coverage for her travel expenses, including transportation and lodging, allowing her to access the best care possible without worrying about the associated costs. The Medigap coverage provided by TrustedCare gave Mrs. Ramirez the freedom to prioritize her health without sacrificing her financial stability.
Case Study 4: EverLife Insurance Company
Mr. Johnson, an 70-year-old retiree, faced unexpected hospitalization and subsequent surgery. While Medicare covered a significant portion of his medical bills, he was still responsible for a substantial deductible and coinsurance. Thankfully, Mr. Johnson had chosen a Medigap plan from EverLife Insurance Company.
With this coverage, he was able to minimize his out-of-pocket costs, making the financial impact of his medical emergency more manageable. The Medigap policy from EverLife helped Mr. Johnson focus on his recovery and regain his health without undue financial stress.
Medicare Supplement Plans (Medigap): The Bottom Line
Medicare Supplement Plans (Medigap) are an excellent option for Medicare recipients needing additional coverage. Because Original Medicare plans don’t always cover every healthcare service, Medicare Supplement Plans (Medigap) fill in where it falls short.
Medigap covers coinsurance, copays, and deductibles but does not cover services like long-term care, dental care, vision care, and more.
Medicare Supplement Plans are often confused with Medicare Advantage Plans because they are similar. Medicare Advantage Plans also cover healthcare services that Original Medicare Plans do not. However, they provide additional benefits.
Medicare Supplement Plans only complement the benefits already available to you through your current Original Medicare Part A or B plan. Both Medicare Supplement Plans and Medicare Advantage Plans have their benefits, so you must talk with an agent to discuss which one would be the best fit for you.
Once you turn 65 and are already enrolled in an Original Medicare Plan, you become eligible to register for Medicare Supplement Plans (Medigap). You may research and choose your plan and company through Medicare’s official website.
We recommend that you compare Medicare Supplement Plans from at least three different companies before deciding on a policy. This will help you choose the best Medicare Supplement Plans (Medigap) company for your needs.
Ready to buy Medicare Supplement Plans (Medigap)? Enter your ZIP code into our free online tool for instant health insurance quotes from companies near you today.
Frequently Asked Questions
What is Medigap coverage?
Medigap, also known as Medicare Supplement Health Insurance, is private health insurance that helps fill the gaps in Original Medicare coverage. It is designed to pay for certain out-of-pocket costs such as deductibles, coinsurance, and copayments, which are not covered by Medicare Part A and Part B.
Who is eligible for Medigap coverage?
To be eligible for Medigap coverage, you must be enrolled in Medicare Part A and Part B. In most states, you can purchase a Medigap policy if you are 65 years or older. However, eligibility rules may vary, so it’s important to check the specific requirements in your state.
When is the best time to buy a Medigap policy?
The best time to buy a Medigap policy is during your Medigap Open Enrollment Period. This period lasts for six months and begins on the first day of the month in which you are both 65 years old or older and enrolled in Medicare Part B. During this period, you have guaranteed issue rights, meaning insurance companies cannot deny you coverage or charge you higher premiums based on pre-existing conditions.
What does Medigap coverage include?
Medigap plans are standardized and labeled with letters (e.g., Plan A, Plan B, etc.). While the specific benefits may vary by plan, all Medigap policies generally cover certain basic benefits, including Medicare Part A coinsurance and hospital costs, Medicare Part B coinsurance or copayments, and the first three pints of blood for a medical procedure. Some Medigap plans may also offer additional benefits such as coverage for skilled nursing facility care or foreign travel emergencies.
What does Medigap coverage not include?
Medigap coverage does not include prescription drug coverage (Part D). If you need prescription drug coverage, you will need to enroll in a standalone Medicare Part D plan. Medigap also does not cover other services not covered by Medicare, such as long-term care, dental care, vision care, or hearing aids.
Are you looking for free insurance quotes?
Your one-stop online insurance guide. Get free quotes now!
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Daniel Walker
Licensed Insurance Agent
Daniel Walker graduated with a BS in Administrative Management in 2005 and has run his family’s insurance agency, FCI Agency, for over 15 years (BBB A+). He is licensed as an insurance agent to write property and casualty insurance, including home, life, auto, umbrella, and dwelling fire insurance. He’s also been featured on sites like Reviews.com and Safeco. To ensure our content is accura...
Licensed Insurance Agent
Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything insurance related. We update our site regularly, and all content is reviewed by insurance experts.