What is Medigap

Medigap came into existence to fill in the inadequacies of the original Medicare plan. Medicare, which combines Part A hospital insurance and Part B medical insurance, covers many health related expenses, but lacks coverage in many areas. The areas that Medicare does not include coverage in are: co-payments, co-insurance and deductibles. In addition, the Medicare plan does not provide coverage for any medical emergencies occurring outside of the United States of America. Some Medigap polices will cover holders outside of the USA.

Medigap is a voluntary system and one is responsible for enrollment. Payments for Medigap may be made monthly or quarterly. It should also be noted that Medicare will not cover any of the cost of Medigap. This is a completely separate policy.

How Does Medigap work with Medicare?

Here is how Medigap works with Medicare. If one is enrolled in Medicare (with Plan A and Plan B coverage) and has a Medigap policy, Medicare will pay its agreed upon portion of health care costs incurred first. Then the Medigap policy is used to pay its share of the remaining costs.

To acquire a Medigap policy one will need to contact a private insurance company. Make sure that Medigap polices are identified as Medicare Supplement Insurance. Also make sure that each policy follows federal and state laws, which were implemented to protect the consumer. The only Medigap policies that a private insurance company should be selling are those designated by the letters A through L.

It is also important to note that regardless of the vendor, a policy designated by, for example, the letter “A”, should be identical to all other vendors “A” polices – prices may vary, but never the coverage. So make sure and check that the benefits offered by one company are identical to those offered by another. This rule is in effect regardless of the state the policies are offered in.

The cost of the Medigap plan you purchase is completely dependent on the level of coverage desired and the vendor you choose. The level of benefits available corresponds with the letter values assigned. Plan A, offers the lowest level of coverage. Plan L, offers the highest level of coverage and is priced accordingly. The two most popular plans, according to the Medicare Rights Center, are C and F. Both cover what would be considered major benefits, but are less expensive than the premium plans. Although Medicare sets the guidelines for what each Medigap plan must offer, it does not set the pricing. That is left up to the private insurance companies.

One is not permitted to purchase a Medigap Policy if one already has a Medicare Advantage plan. It is actually illegal to be sold a Medigap policy if you already have an advantage plan. One’s Medicare Advantage plan will already include all of the Medigap benefits. So be certain to familiarize yourself with Medicare’s Medigap rules. Also take care if buying additional polices that you are not purchasing duplicate or overlapping coverage.

Cris Brines is the CEO of medicaresupplementshop.com. Our insurance experts make selecting the right Medicare supplement plan easier by giving expert advice about the Medicare Supplement plans offered in your area. When we compare all plans and prices you are assured that you have saved as much money as possible while still receiving excellent coverage!


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