8 Key Things to Know About Medigap (Medicare Supplement) Policies

1. You Must Have Original Medicare to buy a Medigap policy, you must be enrolled in both Medicare Part A and Part B.

2. Switching From Medicare Advantage If you have a Medicare Advantage Plan, you can apply for a Medigap policy—but you’ll need to leave your Advantage Plan before the Medigap coverage begins.

3. You’ll Pay an Additional Premium Medigap policies have a monthly premium paid to the private insurance company. This is in addition to your monthly Part B premium paid to Medicare.

4. Medigap Covers One Person Each Medigap policy only covers one person. If both you and your spouse want coverage, you'll each need your own policy.

5. Buy From Any Licensed Insurer in Your State You can purchase a Medigap plan from any insurance company licensed to sell in your state.

6. Guaranteed Renewable As long as you pay your premiums, your Medigap policy is guaranteed renewable—even if you develop health problems.

7. No Drug Coverage in New Plans Medigap policies sold after January 1, 2006, do not include prescription drug coverage. You’ll need to enroll in a separate Medicare Part D plan if you want help with medication costs.

8. Medigap and MSA Plans Don’t Mix If you’re enrolled in a Medicare Medical Savings Account (MSA) Plan, it’s illegal for anyone to sell you a Medigap policy.

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What Medigap Doesn’t Cover

Medigap policies generally do not cover:

• Long-term care

• Vision or dental services

• Hearing aids or eyeglasses

• Private-duty nursing

• Prescription drugs (sold after 2006)

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Not All Insurance Is Medigap

The following types of insurance are not Medigap plans:

• Medicare Advantage Plans (HMO, PPO, PFFS)

• Medicare Prescription Drug Plans (Part D)

• Medicaid

• Employer or union group plans (including FEHBP)

• TRICARE or VA benefits

• Long-term care insurance

• Indian Health Service or Tribal Health plans

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Thinking About Dropping Medigap?

If you decide to drop your entire Medigap policy (not just drug coverage), plan ahead. Switching to another Medigap policy or a Medicare Advantage Plan with drug coverage is possible—but timing matters.

Important:

If you go more than 63 days without creditable prescription drug coverage, you could face a late enrollment penalty when you join a Medicare Part D plan.

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Have questions or need help reviewing your options? Contact us today for a free, no-pressure consultation. We’re here to help you make sense of it all.