Medigap insurance is designed to cover the gaps in Original Medicare Parts A and B only (deductibles and coinsurances). Medigap insurance is offered in various plans known as Standardized Plans (A through N).
Each of these plans are required to provide a set of basic benefits, with some Medigap policies designed to offer additional coverage. Depending on the plan you choose will determine your premium costs.
Original Medicare Medigap insurance can help pay the out-of-pocket costs, up to set policy limits. Some policies will cover a portion of the cost of treatment if you become ill while out of the country.
Medigap insurance is formally referred to as “Medicare Supplemental Insurance.” It’s important to note that Medigap plans do not include coverage for prescription drugs (Part D) or dental, vision, and hearing expenses.
When selecting a Medigap plan, you can purchase a separate Prescription Drug Plan (PDP). This approach helps you avoid expensive penalties if you delay enrolling in Part D later, providing you with a 63-day window to maintain credible drug coverage and avoid any penalties.
If you want Dental, Vision, and Hearing, you have the option to purchase these benefits through a separate “Buy Up” plan for an additional premium.
Am I Eligible for a Medigap Plan?
To qualify for a Medigap plan, you must be enrolled in both Medicare Part A and Medicare Part B, and you’ll be required to cover a monthly premium for the Medigap insurance.
These policies provide coverage for individuals, not couples. Therefore, both spouses or partners must each have their own policy. Certain carriers may offer a household discount if both spouses or companions have their own Medigap plan.
If you are currently enrolled in a Medicare Advantage Plan (Medicare Part C), you cannot qualify for Medigap insurance unless you decide to switch to Original Medicare, which includes both Medicare Part A and Part B.
Selecting the right Medicare insurance can be challenging and confusing. Everyone’s needs are unique, and the plan you choose matters.
Call Cole Insurance and Senior Solutions to schedule an appointment today. We’ll provide education on Medicare, explain Medigap options, costs, and benefits, and help you make informed decisions that suit your needs and preferences.