What is the best supplemental health insurance for medicare

What Is Medigap?

Original Medicare (Part A and Part B) covers most — but not all — the costs of approved health-care services and supplies. After you meet your deductible, you pay your share of the expenses as you get them. There’s no limit to what you’ll pay out of pocket in a year unless you have other coverage, such as Medigap.2 Medigap fills in the potentially costly gaps of Original Medicare — and provides some much-needed peace of mind.

To sign up for a Medigap plan, you must be enrolled in Medicare Part A and Part B. Then you’re set to start Medigap shopping! Ten Medigap insurance plans are each assigned a letter of the alphabet (although Wisconsin, Minnesota, and Massachusetts do things slightly differently). Each Medigap plan is standardized, which means, for example, the basic benefits you receive under Medigap Plan G are the same in Kentucky as in California.

Quick Tip: Want to learn more about different Medigap plans and what benefits they offer? Visit our 2022 guide to Medigap.

What Does Medigap Cover?

As you explore Medigap plans, it’s crucial to consider which benefits are most important to your health and wellness. The 10 Medigap plans (A, B, C, D, F, G, K, L, M, and N) all offer varying levels of coverage. Key factors include:

• Part A deductible
• Part A hospice care copayment or coinsurance
• Part B deductible, excess charges, copayment, or coinsurance
• Skilled nursing facility care coinsurance
• Blood transfusions
• Foreign travel emergencies
• Out-of-pocket limits

Use the Medicare.gov Medigap policy search to find the companies selling the plan of your choice in your ZIP code. From there, compare the premium prices and other factors important to you. For example, you may want to consider customer support, in-person agents, whether you already have policies with the company, or whether you can purchase additional policies such as a Part D plan or dental insurance. It can be tricky to change your Medigap plan once you enroll, so choose carefully and think about potential rising premium costs down the road.

Are Medigap and Medicare Advantage the Same?

Although the names sound similar, Medicare Supplemental plans are not Medicare Advantage plans. Medicare Advantage plans (also known as Medicare Part C) are ways to get Medicare benefits, while a Medigap policy only supplements Original Medicare. If you have a Medicare Advantage Plan, it’s illegal for anyone to sell you a Medigap policy unless you’re switching back to Original Medicare.3

From the Pros: Some Medicare Advantage plans cover “extras,” such as dental, vision, and prescriptions. If you’re deciding between Medigap and Medicare Advantage, visit our Medigap and Medicare Advantage comparison guide.

Why Should Seniors Consider Medigap Plans?

The reality is that original Medicare pays only about 80 percent of your hospitalization and medical office costs. Medigap plans help keep your costs predictable.

Seniors should consider Medigap plans for these reasons:

• They’re guaranteed renewable as long as you pay your premiums on time and don’t misrepresent information on your application.
• They lower the cost of copays, coinsurance, deductibles, and other charges.
• You have more flexibility to travel out of the country and have medical costs covered under certain plans.
• You can choose any doctor or hospital that accepts Medicare.

How Much Do Medicare Supplemental Insurance Plans Cost?

Medigap plan costs depend on several factors, such as:

• Whether it is your open-enrollment period.
• Whether you’ve paid your premiums on time.
• The particular insurer.
• Your age, gender, tobacco use in the past 12 months, and ZIP code.
• The plan itself. Generally, the more things a Medigap policy covers, the higher the premium.

If you’re unsure how these factors will affect your finances, we have you covered! Let’s take a closer look at a few of the key components mentioned above that impact Medicare Supplemental Insurance pricing. As you shop for a Medigap plan, consider how these will positively (or negatively) affect your monthly premium.

Medigap Enrollment

Pay close attention to the calendar as you near your Medicare eligibility window. Your six-month Medigap open-enrollment period begins the month you turn 65 and enroll in Medicare. If you choose to sign up for Medigap outside the open-enrollment period, you may incur a late penalty or higher rates, or be denied coverage altogether. There are certain exceptions to that rule, however, which we’ll cover below in greater detail.

Medigap Insurance Provider

To protect consumers, every Medigap policy is standardized. That means no matter which state you live in, the basic Medigap plan benefits will be the same across the board.4 Unfortunately, Medigap pricing is not standardized, which makes it critical to compare costs to ensure you select a policy that meets your medical and budgetary needs.

Location

Your ZIP code plays a major role in Medigap rates because of cost-of-living variations and clusters of senior citizen communities. If you live in Miami, for example, you’ll pay significantly more than if you live in Fort Worth, Texas. You may save money by going with a Medicare Advantage (Part C) Plan instead of getting Medigap insurance.

Age

As you research Medigap plans, it’s crucial to ask how the provider rates its policies. Insurers in many states use attained-age policies: The younger you are, the less you pay. Some insurers, however, such as AARP from UnitedHealthcare, use a community-based approach. Whether you’re 65 or 85, the premium will be the same. Keep in mind, even community-based premiums can still increase from year to year due to factors such as inflation.

In eight states — Arkansas, Connecticut, Maine, Massachusetts, Minnesota, New York, Vermont, and Washington — insurers must use community ratings. These insurers can still charge different rates depending on tobacco use, ZIP code, and other factors, but they cannot charge more for someone who is older or has more health issues.

Budget-Friendly Tip: Are you and your partner shopping for Medigap plans? Don’t forget to ask if the carrier offers a household discount.

When Is the Best Time to Enroll in Medigap?

Open enrollment is typically the best time to get a plan. This six-month period automatically starts the first month you have Medicare Part B (medical insurance) and are 65 or older. During this period, you get what insurers call the “preferred” rate regardless of any pre-existing conditions you may have. Enroll outside this period and you may have to pay “standard” rates. It’s also possible for your application to be rejected if you seek Medigap outside the open-enrollment period.

There are, however, special enrollment exceptions, and you may still qualify for Medigap without incurring hefty penalties. In these situations, an insurance company can’t deny you a Medigap policy, place conditions or exclusions for pre-existing conditions, or charge you more for a Medigap policy because of a past or present health problem.5

Did You Know: If you live in Connecticut, Maine, Massachusetts, or New York, your Medigap options come with an extra level of security. These states must offer all Medicare beneficiaries ages 65 and older either continuous or annual guaranteed open enrollment. That means you can’t be denied coverage due to your medical history.6

Suppose you’re waiting to enroll in Medicare Part B and Medigap because you (or your spouse) are currently working and have group health insurance coverage. In that case, you still have a penalty-free Medigap open-enrollment period past your 65th birthday, since open enrollment begins when the employer’s coverage ends — when you retire, for example.

Guaranteed issue rights (also called Medigap protections) are rights you have in certain situations even if your open-enrollment period ends. You have a guaranteed issue right if you’re currently in a Medicare Advantage plan that is leaving Medicare or stops giving care in your area, for example. You’re guaranteed the right to buy a Medigap plan sold by any insurance company in your state.

Medigap Plans for Every Need

We know that insurance plans aren’t one-size-fits-all. That’s why we’ve put together our top picks for different needs and lifestyles:

• Best Medigap plans for healthy seniors
• Best Medigap plans for low-income seniors
• Best Medigap plans for seniors with cancer
• Best Medigap plans for those with diabetes
• Best Medicare Part D plans

Learn More About Medicare and Medigap Coverage

If you are looking to learn more about Medicare and Medigap coverage, check out the video below for an Introduction to Medicare from the Senior Living YouTube channel. Here, you will find information about different plan types and Medigap, as well as alternative sources for Medicare information.

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