Medigap (Medicare Supplement Health Insurance) Coverage: An Expert Guide (2024)

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.

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.

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.

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.