Medicare Supplement Insurance (Medigap)

Medicare Supplement Insurance (Medigap) helps fill "gaps" in Original Medicare and is sold by private companies. Original Medicare pays for much of the cost for covered health care services and supplies, but it does not pay for all.

Medicare Supplement Insurance (Medigap) can help pay some of the remaining health care costs, like:

• Deductibles
• Copayments
• Coinsurance

Medigap policies do not cover everything:

• Long-term care
• Vision
• Dental Care
• Hearing aids
• Eyeglasses
• Private duty nursing

Some Medigap policies also cover services that Original Medicare does not cover. For example, medical care when you travel outside the U.S.

If you have Original Medicare and you buy a Medigap policy:

• Medicare will pay its share of the Medicare-approved amount for covered health care costs.
• Then, your Medigap policy pays its share.

KEY POINTS 

• You must have Medicare Part A and Part B.
• A Medigap policy is different from a Medicare Advantage Plan.
• Medigap policy only supplements your Original Medicare benefits.
• Medicare Advantage Plan is a type of Medicare health plan offered by private insurance companies that contract with Medicare to provide all Part A and Part B benefits.
• You pay a monthly premium, directly to the private insurance company, for your Medigap policy. In addition, you pay the monthly Part B premium directly to Medicare.
• A Medigap policy only covers one person, which means if you and your spouse both want Medigap coverage, each person would buy separate policies.
• Medigap policies can be purchased from any insurance company licensed to sell in your state.
• Standardized Medigap policy is guaranteed renewable even if you encounter health problems. The insurance company cannot cancel your Medigap policy if you pay the premium.
• Medigap policies sold after January 1, 2006 do not include prescription drug coverage. You can sign up for a Medicare Prescription Drug Plan (Part D).
• Unless you are switching back to Original Medicare from a Medicare Advantage Plan, it is unlawful for anyone to sell you a Medigap policy.

Some types of insurance are not Medigap plans:

• 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 (FEHBP)
• TRICARE
• Veterans' benefits
• Long-term care insurance policies
• Indian Health Service, Tribal, and Urban Indian Health plans