Medicare supplement insurance, also known as Medigap, helps cover healthcare costs not paid by Original Medicare. These policies are sold by private insurance companies to fill “gaps” in Medicare coverage such as copayments, coinsurance, and deductibles. Enrollment in Medigap is available during a six-month open enrollment period that begins the month you turn 65 and are enrolled in Medicare Part B. There are ten standardized Medigap plans (A, B, C, D, F, G, K, L, M, and N) in most states, each offering different levels of coverage. Understanding the differences between these plans is crucial for selecting the most appropriate coverage for your healthcare needs.
Key Considerations for Medigap Selection
Medigap policies are standardized, meaning Plan G offers identical benefits regardless of which insurance company sells it, though premiums may vary significantly. Some insurance companies offer high-deductible versions of certain plans that feature lower monthly premiums but require paying more out-of-pocket before coverage begins. Medigap policies only cover one person, so spouses need to purchase separate policies even if they use the same insurance company. These policies generally don’t cover prescription drugs, vision care, dental care, hearing aids, or long-term care, requiring additional insurance for these services. Once enrolled in a Medigap policy, it’s guaranteed renewable even if you develop health problems, as long as you pay your premiums. Insurance companies may offer discounts for non-smokers, women, married people, or those who pay annually rather than monthly. Some states have their own specific regulations regarding Medigap policies, particularly Massachusetts, Minnesota, and Wisconsin, which standardize these policies differently.
Transitioning Between Medigap Plans
Switching from one Medigap policy to another may subject you to medical underwriting if you’re outside your initial enrollment period. During medical underwriting, insurance companies can deny coverage or charge higher premiums based on pre-existing conditions. Some states offer annual guaranteed issue rights or “birthday rules” that allow you to switch Medigap policies without underwriting during specific periods. Understanding your state’s specific regulations regarding Medigap policy changes can save you significant money while ensuring continuous coverage.