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medicare supplemental Insurance

What is a Medicare Supplement or Medigap?

A Medicare Supplement, or also know as a Medigap policy, is health insurance sold by private insurance companies to fill the “gaps” in Original Medicare coverage - Parts A & B.  Medicare Supplements help pay towards the health care costs that the Original Medicare alone does not cover.  If you have Original Medicare and a Medicare Supplement policy, Original Medicare will be your primary policy and will pay your claim first, and then your Supplemental policy will be your secondary and will then pay towards the remaining balance of your claim.  These types of policies must be clearly identified as “Medicare Supplement Insurance", not to be confused with a Medicare Advantage (MA) Plan which function very differently during the billing process as well as in many other ways.

Medicare Supplements or Medigap policies are arranged by letter plan (A, B ,C, D, F, G, K, L, M, & N) and each letter plan varies in coverage, but all Medicare Supplements policies sold today do not include Prescription Drug coverage.  Additionally, each supplemental plan is “standardized” meaning that "Plan F", for example, must have the same level of coverage no matter which company sells it although the premium offered by those companies for that same plan can vary greatly.  Each insurance company that sells Medicare Supplements have their own methods to determine the initial premium amount, the renewal premium increase amount, the underwriting criteria for any non-Guaranteed Issue policies, as well as other factors such as application fees, discount programs, and household discount.

When you apply for a Medicare Supplemental policy you must have Medicare Parts A & B in effect no later than the time of the supplement's effective date.  Medicare Supplements can be purchased any time of the year, but there are certain periods in which Medicare beneficiaries should be aware.  These periods are typically known as Open Enrollment and Guaranteed Issue periods where a person would qualify for a Medicare Supplement without underwriting.