Medicare Supplement policies, also known as Medigap insurance policies, are sold by private insurance companies and cover the portion of your healthcare costs that you would normally have to pay for, or the gaps in coverage. In order for a Medicare supplement policy to cover something, the service needs to be covered by Medicare. The Center for Medicare & Medicaid (CMS) determines what services will be covered by Medicare each year. Even if a service is covered by CMS, or Medicare, you’ll still need to pay for part of the costs. The Medigap policy will only pay for the portion that you would be repsonsible for, or the gap. This would include things like your Part A hospital deductible, the Part B deductible, the 20% of physicians charges that Medicare doesn’t pay for, extra blood, charges for extra days in the hospital, etc. Some of the policies even cover things that are not covered by Medicare such as medical care when traveling outside the United States.
Medicare supplement policies were standardized by the government in 2006 to make it easier for Medicare beneficiaries to shop for them. They cover different things and they are identified by letters of the alphabet A – N. As long as the plan letter is the same, it will offer identical benefits no matter what insurance company is offering it. This makes it very easy to shop and compare prices from various insurance companies since you know that the coverage will be the same.
Is there a network I have to worry about?
No. If a doctor or hospital accepts CMS Medicare patients, then it will accept your Medicare supplement policy. There is no network to worry about with these policies. This is different from a Medicare Advantage plan. With Medicare supplement, you can be traveling in another state and use your policy just the same as if you were at home.
Other things to know about Medicare supplement policies
- Each policy only covers one person. If you are married and both of you are on Medicare, you will each need your own Medicare supplement policy. Some companies offer a discount if both of you own a policy from them.
- You must enroll in Medicare Part A and Part B in order to buy a Medicare supplement policy.
- Medicare supplement policies are guaranteed renewable. That means as long as you keep paying your premium they cannot cancel your policy, even if you get sick.
- There is a short period of time when you first become eligible for Medicare where you can buy a Medicare supplement policy no matter how bad your health is. After that, you can be declined for Medicare supplement policies. Don’t wait to enroll! Once you pass this window, you have to qualify for coverage by answering all the health questions!!
- No Medicare supplement policy sold today covers prescription drugs. You need a Part D prescription drug plan for that.
- You cannot buy a Medicare supplement policy if you have a Medicare Medical Savings Account (MSA) Plan.
To see some actual Medicare supplement rates for many states, CLICK HERE.
The Centers for Medicare and Medicaid published a helpful brochure about Medicare supplement policies that you can find here: CHOOSING A MEDIGAP POLICY.