Medicare Supplement (Medigap) Insurance

Medicare Supplement plans (also known as Medigap plans) are generally thought of as the most comprehensive and flexible plans. One of the key benefits of a Medicare Supplement Plan is that there is no “provider network.” You can use any doctor or hospital that accepts Medicare, anywhere in the U.S. And, in most cases, you don’t need a referral to see a specialist.

A Medicare Supplement Insurance plan pays some of the health care costs that Medicare Part A (Hospital) & Medicare Part B (Medical) don’t cover, like coinsurance, copayments, and deductibles. Private insurance companies sell Medicare Supplement Plans. Your claims are sent to Medicare and generally if Medicare approves the service, your Medicare Supplement will also approve the service.

There are ten different Medicare Supplement Plans: A, B, C, D, F, G, K, L, M, N. The plans are standardized by Medicare, meaning that if one insurance company sells Medicare Supplement Plan G it must be identical to another insurance company’s Plan G. For many people, Medicare Supplement Plan G now provides the best value for full, flexible coverage.

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Guaranteed Issue Coverage: One of the most important things to know about Medicare Supplements is that you must apply for your Medicare Supplement within six-months of your Medicare Part B effective date in order to be guaranteed issue for coverage. This six-month window is called your Medigap Open Enrollment Period. During this period, you can sign up for any Medicare Supplement Plan. You do not have to go through underwriting or answer health questions to get the coverage. You are guaranteed the coverage.

If you miss your Medigap Open Enrollment Period, you will have to be underwritten for a Medicare Supplement plan in most cases. This means the insurance company can deny you coverage. For example, they may deny you if you have certain previous or ongoing health conditions, like joint replacement, surgery for cancer, congestive heart failure, coronary artery disease, diabetes with circulation problems, TIA, stroke, heart attack, and heart disease.

Medicare Supplement Plans do not provide outpatient prescription drug coverage for medicines you get from your pharmacy like Walgreen or CVS. Outpatient Prescription drug coverage is provided by Medicare Part D plans.

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