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What is Medigap or Medicare Supplement Insurance?

Sep 4, 2021

Medicare Supplement Insurance (also known as Medigap) is an insurance policy offered by private health insurers to cover some of the co-payments, deductibles and co-insurance that the original Medicare does not cover.

How does Medigap work?  It’s simple: When you go to your healthcare provider, simply present both your original Medicare card and your Medigap insurance card. Medicare will pay its share of approved charges, and then your Medigap policy will pay its share of the co-pays, deductibles and coinsurance.

See below for a few key points about Medigap policies:

  • You must have Medicare Part A and Part B to buy a Medigap policy.
  • Medigap is not the same as a Medicare Advantage Plan.  You do not need Medigap coverage if you have a Medicare Advantage Plan.  In fact, it’s illegal for someone to sell you coverage of you do!
  • Medigap is offered by a private insurance company, not the federal government, therefore all premiums are paid by you to the insurance company directly, not by Medicare.
  • Medigap only covers one person, family coverage is not available. For a married couple, each must have their own policy.
  • Medigap policies from different insurance companies offered in the same State (i.e. Florida, for example) have the same benefits; meaning, a Medigap Part F policy from company A is the same as from company B.  The only difference is the premium.
  • Standardized Medigap policies are guaranteed renewable. This means that the insurance company cannot cancel your policy as long as you pay your premiums, even if you have health problems.
  • Medigap policies sold after January 1, 2006 do not have prescription drug coverage. If you want prescription drug coverage you have to join a Medicare Prescription Drug Plan (Part D).

Would you like more information? Contact a NAOSA Medicare Supplement Expert Member near you

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