Medigap Glossary of Terms
Medigap is a Medicare Supplement Insurance plan that pays for extra costs not typically covered by Original Medicare. This generally includes copayments, coinsurance, and deductibles. Medigap plans may also cover medical care needed when traveling outside of the United States, among other costs.
Read More: What is Medigap and Do I Need It?
Medigap (Medicare Supplement) plans are sold by private insurance companies that have been licensed in your state. Medigap is different from Medicare Advantage Plans and may not cover Part D prescription medication costs. The specific items that are covered by your Medigap plan will vary depending on which plan you choose.
Medigap plans can be categorized as:
Medigap plans can vary drastically throughout the country. In most states, different Medigap plans are identified by letters (A, B, C, D, F, G, K, L, M and N).
The state of Minnesota is somewhat unique when it comes to Medigap policies: We offer 4 types of Medicare Supplement plans: Extended Basic, Basic, Co-Pay Plan N, High Deductible Plan F.
What You Need to Know About Medicare Supplements in Minnesota
The basic benefits that you’ll receive in Minnesota cover items like inpatient hospital care, Part B coinsurance, the first 3 pints of blood each year, Part A hospice and respite care cost-sharing, as well as Parts A and B home health services and supplies cost-sharing.
Although this varies between plans, most Medigap policies do not cover:
There is no standard cost for Medigap plans. Each insurance company that offers Medigap sets its premiums. When deciding between Medigap plans, make sure to understand how the insurer prices its policies. This can affect how much you pay now, and also how much you could pay in future years.
Medigap premiums are set in one of three ways:
Read More: 7 Medicare Facts You May Not Know
Other factors could influence Medigap policy costs, such as:
Most Medigap plans are guaranteed renewable plans. This means that benefits will remain consistent, even if your health needs change. As long as you continue to pay the premium, the insurance company cannot cancel your Medigap policy. (The premiums may change, however.)
Both Medigap and Medicare Advantage Plans provide coverage through a private insurance company. Medicare Advantage Plans (also known as Medicare Part C) generally cover Medicare Parts A, B, and D. In addition, Medicare Advantage Plans usually provide dental, vision, and wellness benefits.
Medigap plans don’t work with Medicare Advantage Plans – you can’t use Medigap to pay Medicare Advantage premiums, copays, and deductibles. Therefore, if you have a Medigap policy and decide to change to a Medicare Advantage plan, you would need to cancel the Medigap plan.
Medicare Advantage vs Medicare Supplements: Which One Is Right For Me?
If you join a Medicare Advantage Plan for the first time and are unsatisfied with the plan, federal law grants you the right to buy a Medigap policy. This right only applies if you return to Original Medicare within 12 months of joining the Medicare Advantage Plan.
Are you unsure about which Medicare plan is right for you? Contact Twin City Underwriters.
Medigap plans do not cover prescription drug costs. In order to obtain drug coverage and avoid penalties, you would need to purchase a separate Medicare Part D plan. Learn more about Medicare Part D here.
The best time to buy a Medigap policy is when you are first eligible. This Medigap Open Enrollment Period is a six-month window that starts the month you’re 65 or older and enrolled in Medicare Part B. During this time, you can buy any Medigap policy offered in your state, even if you have health issues, and you can’t be charged more for coverage.
If you miss this window, you can still apply for a Medigap policy at any time, but approval and pricing may depend on your health history unless you qualify for a guaranteed issue right (for example, if you lose other coverage or move out of your plan’s service area).
New rules and legislative updates could expand Medigap options.
Learn what's changing and how it could affect your enrollment options.
There are a few simple steps involved in purchasing a Medigap policy:
Get the Right Coverage with Twin City Underwriter’s SurePlan® Medicare System
If you’re traveling outside the United States, you could be entitled to additional coverage for emergency health care services or supplies.
With Medigap plans, you may receive coverage benefits such as:
Read: Traveling with Original Medicare and Medicare Supplements
Though you may be covered, foreign travel emergency coverage with Medigap policies has a lifetime limit.
Talk with an agent from Twin City Underwriters for more information on traveling with Medigap. You’ll get personalized advice that meets your needs.
Get all the answers to your Medicare questions in our Medicare Resource Guide.
Do you have questions about Medicare and which plan is right for you? Twin City Underwriters offers free informational Medicare webinars and one-on-one meetings with agents where you can ask questions and get personal answers. We can help you select the right coverage for your needs. To attend a webinar or set up an appointment, call us at 651-488-0172 or send us a message.
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