What is Medicare Supplement?

If you have Original Medicare, you already know that Part A covers hospital stays and Part B covers doctor visits and outpatient care.

But there's something important to understand about how these two parts work together: they don't cover everything and may need to be supplemented.

What is a Medicare Supplement Plan?

Original Medicare pays a large share of your approved medical costs, but it typically leaves you responsible for 20% of outpatient services with no cap on what you could owe out of pocket each year. For people with ongoing health needs, that gap can add up quickly.

• That's where Medicare Supplement Insurance, also called Medigap, comes in. 

• Medigap is private health insurance sold by insurance companies and approved by Medicare. 

• These plans are designed to work alongside Original Medicare, helping fill in the costs that Parts A and B don't fully cover. 

• Depending on the plan you choose, Medigap may help pay your Part A and Part B deductibles, coinsurance, and copayments. Some plans also include coverage for emergency care during foreign travel.

Medicare Supplement Plan Types

There are ten standardized Medigap plan types, labeled Plan A through Plan N (Plans E, H, I, and J are no longer sold to new enrollees; Plans C and F are limited to those that were eligible for Medicare prior to January 2020). 

• Because these plans are standardized by the federal government, the benefits within each plan letter are the same no matter which insurance company sells it. 

• Massachusetts, Minnesota, and Wisconsin have their own plan structures that differ from the standard.

• The difference between carriers is typically premiums, rate stability, and customer service.

Important: if you have a Medicare Advantage plan (Part C), you cannot also have a Medigap policy. 

• Medigap is designed specifically for people enrolled in Original Medicare (Parts A and B).

When to Enroll in Medicare Supplement

The best time to buy a Medigap policy is during your Medigap Open Enrollment Period: the six-month window that begins the month you turn 65 and are enrolled in Part B. 

• During this time, insurers cannot deny you coverage or charge you more based on your health history. 

• Once this window closes, you may face medical underwriting, which could result in higher premiums or denial of coverage depending on your health status.

Contact SGIA Today

Understanding how Medigap works is an important first step in building a Medicare coverage plan that makes sense for your health and your budget.

SGIA Medicare Consulting can help you compare Medigap options and determine which plan best fits your needs. Visit sgiamedicare.com to connect with our team.