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What is a Medicare Supplement Plan?

Original Medicare pays for many, but not all, health care services and supplies. A Medigap policy, sold by private insurance companies, can help pay some of the health care costs (“gaps”) that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, both plans will pay their share of Medicare approved amounts for covered health care costs. Medicare doesn’t pay any of the costs for a Medigap policy.
Every Medigap policy must follow Federal and state laws designed to protect you, and it must be clearly identified as “Medicare Supplement Insurance.” Medigap insurance companies can sell you only a “standardized” Medigap policy identified in most states by letters, Plans A through N. All plans offer the same basic benefits but some offer additional benefits, so you can choose which one meets your needs.

If You Want to Buy a Medigap Policy

Generally, you must have Part A and Part B to buy a Medigap policy.
  • You pay a monthly premium for your Medigap policy to the private insurer, and you pay your monthly Part B premium.
  • A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you must each buy separate policies.
  • It’s important to compare Medigap policies since the costs can vary and may go up as you get older. Some states limit Medigap costs.
  • The best time to buy a Medigap policy is during the 6-month period that begins on the first day of the month in which you are both age 65 or older and enrolled in Part B. (Some states have additional open enrollment periods.) After this initial enrollment period, your option to buy a Medigap policy may be limited.
  • If you are under age 65, you may have additional rights to buy a Medigap policy, depending on the laws in your state.
  • If you have a Medigap policy and join a Medicare Advantage Plan (like an HMO or PPO), you may want to consider dropping your Medigap policy. You can continue to pay your Medigap premium, but your policy can’t be used to pay your Medicare Advantage Plan copayments and deductibles.
  • If you want to drop your Medigap policy, you must contact your insurance company to cancel the policy.
  • If you already have a Medicare Advantage Plan, it’s illegal for anyone to sell you a Medigap policy unless you are switching back to Original Medicare.
  • If you join a Medicare health plan for the first time, and you aren’t happy with the plan, you will have special rights to buy a Medigap policy if you return to Original Medicare within 12 months of joining.

    - If you had a Medigap policy before you joined, you may be able to get the same plan back if the company still sells it.

    - The Medigap policy can no longer have prescription drug coverage even if you had it before, but you may be able to join a Medicare Prescription Drug Plan.

    - If you joined a Medicare health plan when you were first eligible for Medicare, you can choose from any policy.
  • If you buy a Medicare SELECT policy you also have rights to change your mind within 12 months and switch to a standard Medigap policy.
  • You can’t have drug coverage in both your Medigap policy and a Medicare drug plan.

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