Medicare Supplement Insurance (Medigap)

Commonly referred to as Medigap, Medicare Supplement Insurance offers you the coverage you need to fill the gaps in your Original Medicare benefits.

What is Medical Supplemental Insurance?

Also referred to commonly as “Medigap”, is a secondary insurance that complements Original Medicare (Parts A and B). It helps cover out-of-pocket expenses that Original Medicare doesn’t fully pay, such as coinsurance, copayments, and deductibles. By enrolling in a Medigap policy, you can reduce your financial burden and ensure that you get the care you need without worrying about unexpected expenses.

Medicare Supplemental Insurance covers your share of costs for services that are not covered by Original Medicare only.

Copayments: This is an amount that may be required to be paid as your share of the cost for benefits once any deductibles are paid. This is usually a fixed amount.
Coinsurance: This is an amount that may be required to be paid as your share of the cost for benefits once any deductibles are paid. This is usually a percentage.
Deductibles: This is an amount you need to pay for prescriptions or healthcare before Original Medicare, your Medicare Advantage Plan, your Medicare drug plan, or other insurance begins to pay.

Medigap doesn’t cover:

Long-term care, such as nursing home care
Vision or dental care
Hearing aids
Eyeglasses
Private-duty nursing
Prescription drugs

How to Find the Right Medigap Policy for You

When it comes to finding the right Medigap policy, you need to find the right option for your unique needs. Here are a few steps to help you find the right fit for your healthcare requirements.

Step 1: Understand Your Needs

Consider your current health status and anticipated medical expenses to choose the most suitable plan. Medigap policies are standardized and in most states, they are named by letters, Plans A to N. Consider the benefits of each plan and what they pay for. With plans covering everything from foreign travel emergencies to copays, choose a plan that covers what you need.

Step 2: Compare Available Plans

Find and compare policies in Western Pennsylvania. Research the many Medigap plans (A through N) available and look for a plan that aligns with your budget and your coverage needs. Price remains the sole difference between these policies, even though they are offered by different Medicare insurance companies. Consider all your options before making your final decision.

Step 3: Enroll at the Right Time

Familiarize yourself with the open enrollment period and any potential health underwriting requirements to secure the best Medicare Supplement Insurance option for yourself. All Medicare beneficiaries who are enrolled in Part A and Part B of Original Medicare are eligible to apply for a Medicare supplement. However, you may need to pass medical underwriting to be issued one of these policies. If you are applying during your Initial Enrollment Period, you are eligible to choose any Medicare supplement without answering health questions. Your IEP is a window of time around either your 65th birthday or when you enroll in Medicare Part B if you chose to work longer. Enrolling outside this period may lead to higher premiums, and in some cases, denial of Medigap coverage because enrolling outside of OEP subjects you to medical underwriting.

Step 4: Contact 724 Medicare for Assistance

As a Medicare Insurance Specialist in Western Pennsylvania, 724 Medicare is dedicated to helping you navigate the complexities of Medigap. Our team of experienced Medicare Insurance agents understand the unique healthcare needs of our community and will guide you through the process of selecting the right Medigap policy for your specific needs.

Make an Appointment

Frequently Asked Questions

Below are some commonly asked questions about Medicare Supplemental Insurance:

Can I have both Medigap and Medicare Advantage?

You have the option of purchasing Medigap or enrolling in a Medicare Advantage Plan. However, you cannot have both. If you already have a Medicare Advantage Plan, you cannot get a Medigap policy.

Do Medigap policies cover my spouse?

Medigap policies are individual policies, meaning they only cover one person. If both you and your spouse want Medigap coverage, you’ll need to purchase separate policies.

Do Medigap policies cover prescription drugs?

No, Medigap policies sold after 2005, do not include prescription drug coverage. For prescription drug coverage, you’ll need to enroll in a separate Medicare Part D plan or choose a Medicare Advantage plan that includes drug coverage.

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