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What Is Medigap?

Nov 15, 2019 3 min read Ben Gran

If you or a loved one are about to become eligible for Medicare and you're researching your options for coverage, you might have heard of something called Medigap.

What is Medigap? Also known as Medicare Supplement Insurance, it can help cover the "gaps" and out-of-pocket costs that aren't paid for by Original Medicare (Medicare Part A, Part B and Part D).

Learn more about how Medigap plans can help cover your out-of-pocket costs and manage your total health care costs under Medicare.



How much does Medicare really cost?

Medicare is not free health care. Even when you have Medicare coverage, you still might have to spend significant amounts of money on deductibles, coinsurance and copays. Learn more about Medicare costs Opens in new window.

When you consider how complex and costly health care can become for seniors during the late stages of life, it might make sense to purchase Medigap coverage to help protect you and your family from those potentially big bills.


What is Medigap and what does it cover?

If you want to learn more about Medigap, start with the Medicare.gov website. It offers a Medigap plans comparison chart Opens in new window to show which costs they cover.

There are a total of 10 different Medigap plans with different levels of coverage. If you're newly eligible for Medicare as of Jan. 1, 2020, or later, two of the Medigap plans (Plans C and F) are no longer available.

In general, all Medigap plans cover:

  • Medicare Part A coinsurance and extra hospital costs (up to an additional 365 days of hospital care after Medicare benefits are used up).
  • Medicare Part B coinsurance or copayments.
  • Blood transfusions (first three pints of blood).
  • Medicare Part A coinsurance/copayment for hospice care.

Some Medigap plans (K and L) won't cover 100% of these costs. Others may not cover skilled nursing facility care coinsurance "excess charges" from doctor visits or emergency medical care during foreign travel.

Read the details and understand your options before choosing a Medigap plan. Some plans might offer lower premiums but won't cover all of your possible costs at the same level as others.


Finding a Medigap policy

To more fully understand the range of options, benefits and prices of Medigap plans, use the Medicare.gov tool Opens in new window and enter your ZIP code. Medigap plans are different depending on where you live. Some states (Massachusetts, Minnesota and Wisconsin) also have their own different Medigap plans with benefits that are required by that state.

The tool is the best way to clearly see the options available in your state, understand the price range and find an insurance company that offers the plan.


Don't wait to buy Medigap coverage

If you want to buy a Medigap policy, you need to act quickly. The best time to buy is when you turn 65, during your six-month Medigap open enrollment period. If you don't buy Medigap during this time frame, you might not be able to buy it in the future. If you buy a policy later, you might need to pay a higher premium or have exclusions for certain preexisting health conditions.

Medigap plans should be part of your overall financial planning when getting ready to retire or enroll in Medicare. These plans can be complicated, and not every plan offers the same levels of coverage. But if you're willing to do the research and able to spend a bit more money for Medigap premiums, these plans can potentially help protect you and your loved ones from the extra costs of health care for the rest of your life.



Ben Gran is a freelance writer based in Des Moines, Iowa. He writes about personal finance, public policy, financial services, technology, and business.


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