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Writer's pictureNick T.

7 Things You Should Know About Medigap Coverage



What is Medigap Insurance?

While Medicare can cover many of your healthcare costs, you might incur expenses that are not accounted for. Medigap coverage, also known as Medicare Supplement Insurance, is a form of private health insurance designed to supplement Original Medicare. This type of coverage is intended to fill the gaps left by Medicare, including copayments, coinsurance, and deductibles. Medigap insurance may also cover services that are not covered by Medicare, like emergency medical coverage you receive outside of the United States.


Non-Medicare Recipients Won’t Qualify

Only individuals who are enrolled in Medicare Part A and B are eligible for Medigap policies. Part A covers the cost you incur during hospitalization, Part B covers medical visits and routine care, and Medigap is aimed to subsidize your Medicare policy.



Medigap Policy Options

Medigap policies come in a variety of options. There are ten different types of standardized Medigap policies, labeled by letter. Each standardized policy offers the same benefits, regardless of insurance carrier. However, price varies from one company to the next, so you'll want to compare multiple carriers. Depending on the provider, different pricing structures are available. Sometimes, premiums are based on inflation and the recipient’s age, while some policies set premiums based on location. Make sure to select a policy that is appropriate for your specific needs.


Coverage Restrictions

Although Medigap can help you cover out-of-pocket medical expenses, there are some services that are not insured by Medigap policies. For example, Medigap doesn’t include dental insurance, coverage for glasses and contact lenses, or coverage for hearing aids. Medigap policies also exclude prescription drug coverage. For prescription drug insurance, enroll in a Medicare Part D Plan. Need extra cash? This site pays up to 25$ per survey.


Time Window

If you are signed up for Medicare, you can purchase a Medigap policy at any time. However, in order to avoid higher premiums for pre-existing medical conditions, sign up within six months from the day that you enroll in Medicare Part B.


Coverage is Per Individual

In order to utilize Medigap Insurance, each individual must have their own policy. If you and your spouse both wish to obtain Medigap coverage, you will need to purchase two separate policies.



Out-of-Pocket Limit

Depending on your policy, your Medigap plan may have annual limits on your out-of-pocket expenses for Medicare Plan A and B. If you hit your limit, your Medigap policy will cover 100% of expenses until the next policy period.

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