EASY MEDICARE

Medigaps are health insurance policies that offer standardized benefits that work with Original Medicare (not with Medicare Advantage). They are sold by private insurance companies. If you have a Medigap, it pays part or all of certain remaining costs after Original Medicare pays first.

Medigaps may cover outstanding deductibles, coinsurance, and copayments. Medigaps may also cover health care costs that Medicare does not cover at all, like care received when traveling abroad. Remember, Medigaps works only with Original Medicare. If you have a Medicare Advantage Plan, you cannot buy a Medigap.

Depending on where you live and when you became eligible for Medicare, you have up to 10 different Medigap policies to choose from: A, B, C, D, F, G, K, L, M, and N (policies in Wisconsin, Massachusetts, and Minnesota have different names). Each policy offers a different set of standardized benefits, meaning that policies with the same letter name offer the same benefits. However, premiums can vary from company to company.

Note: People eligible for Medicare on or after January 1, 2020, cannot purchase Medigaps that pay for the Part B deductible. This includes Plan C and Plan F. If you became eligible for Medicare before this date, you are still able to purchase Plan C or Plan F.

Before you buy a Medigap policy, be sure to do your research. Some steps you may wish to take include the following:

1. Make sure you are eligible to purchase a Medigap. Remember that you can have a Medigap only if you have Original Medicare. If you are enrolled in a Medicare Advantage Plan, Medigaps cannot be sold to you. There may be other Medigap eligibility requirements that apply to you, depending on the state in which you live.
2. Learn when you have the right to buy a Medigap without restriction. There are federal protections for people older than 65 to buy a Medigap in certain situations. Some states have additional protections for individuals younger than 65 or during other times.
3. Once you decide you need a Medigap and know you are eligible to enroll, compare the different types of policies that exist. As mentioned above, there are 10 different standardized policies in most states, each covering a different range of Medicare cost-sharing.
4. Learn how a Medigap covers previous medical conditions to know if any of your medical costs may be excluded from Medigap coverage. Depending on your circumstances, a Medigap can exclude coverage for previous medical conditions for a limited amount of time.
5. Find out how Medigap premiums are priced, so you can make cost comparisons. To find the best deal for you, it is important to understand the ways that insurers set premiums.
6. Have a list of questions to ask when shopping for a Medigap to remind you what you should consider. Buying a Medigap can be complicated. However, using a set of written questions and asking for help when needed can help you stay organized and simplify the process.

Medigap Policies Don’t Cover Everything

Medigap policies generally don’t cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.

Dropping Your Entire Medigap Policy (Not Just The Drug Coverage)

If you decide to drop the entire Medigap policy, you need to be careful about the timing. For example, you may want a completely different Medigap policy (not just your old Medigap policy without the prescription drug coverage), or you might decide to switch to a Medicare Advantage Plan that offers prescription drug coverage.

If you drop your entire Medigap policy and the drug coverage wasn’t creditable or you go more than 63 days before your new Medicare coverage begins, you have to pay a late enrollment penalty for your Medicare Prescription Drug Plan, if you choose to join one .