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What to Consider
Medigap policies are standardized insurance plans that help cover out-of-pocket costs and additional services not covered by Original Medicare. It is important to understand the enrollment period, coverage limitations, and the fact that Medigap policies cannot be combined with Medicare Advantage or provide prescription drug coverage.
Standardized Plans: Medigap policies are standardized across most states in the U.S., meaning that each plan type offers the same basic benefits, regardless of the insurance company selling it. The only difference is the cost, which can vary among insurance companies.
Coverage: Medigap policies fill gaps in Original Medicare coverage (hence the name), helping to cover out-of-pocket costs like deductibles, coinsurance, and copayments. Some Medigap policies also cover services that Original Medicare doesn't cover, like medical care when you travel outside the U.S.
Enrollment Period: The best time to buy a Medigap policy is during your 6-month Medigap Open Enrollment Period, which begins the month you're 65 or older and enrolled in Medicare Part B. During this period, an insurance company can't use medical underwriting, meaning it can't refuse to sell you any Medigap policy it offers, charge you more based on health problems, or make you wait for coverage to start.
Separate Policies: Medigap policies are sold on an individual basis. If you and your spouse both want Medigap coverage, you'll each have to buy separate policies.
No Prescription Drug Coverage: As of 2006, Medigap policies sold to new people with Medicare aren't allowed to include prescription drug coverage. If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D).
Cannot be Used with Medicare Advantage: Medigap policies can't be used to pay your Medicare Advantage Plan copayments, deductibles, or premiums. If you have a Medigap policy and join a Medicare Advantage Plan (Part C), you may want to drop your Medigap policy.
Pre-Existing Conditions: If you have a pre-existing condition, there might be a delay before your Medigap coverage kicks in. However, if you're switching from a different form of health coverage, you may be able to count that previous coverage toward the waiting period.
Guaranteed Renewable: Medigap policies are guaranteed renewable even if you have health problems. This means the insurance company can't cancel your Medigap policy as long as you pay the premium.