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Original Medicare offers broad coverage to help with certain hospital and medical costs, but doesn’t cover all costs of the services and supplies you may need. Medicare Supplement (Medigap) insurance plans fill in some gaps in basic benefits left behind by Original Medicare.
Medicare Part A and Part B (which make up Original Medicare) have out-of-pocket costs you may have to pay, such as deductibles, copayments, and coinsurance. That’s where Medigap insurance comes in. The various Medigap plans cover various portions of Original Medicare expenses.
There are 10 standardized Medigap plans in 47 states named with letter designations (such as Medigap Plan M). Massachusetts, Minnesota and Wisconsin have their own standardized plans. Each Medigap plan of the same name carries the same basic benefits no matter where you buy the plan. For example, if you buy Medigap Plan M in Boston, it’ll include the same basic benefits as a Medigap Plan M in Laredo. Some companies may offer additional innovative benefits.
Like almost all insurance plans, Medicare Supplement insurance plans do require premium payments. Because Medigap plans are offered through private insurance companies, the costs associated with each plan may differ. So, to follow up with the above example, a Medigap Plan M you buy in Boston may not cost the same as a Medigap Plan M you buy in Laredo, but the basic benefits would be the same.
Each private insurance company offering Medicare Supplement insurance plans can set its own plan premiums using one of these rating methods:
Note that besides your Medigap plan premium, you still need to pay your Original Medicare premium(s) as well; Medigap doesn’t cover your Medicare Part A or Part B premium. Many people don’t pay any Part A premium – if you worked at least 10 years (40 quarters) while paying Medicare taxes, Part A is premium-free. But most beneficiaries pay a monthly Part B premium.
You can apply for a Medigap policy anytime you’re enrolled in both Medicare Part A and Part B, but when you apply can make a big difference – both in terms of whether you’re accepted into the Medigap plan, and in terms of other details, including cost.
Your first opportunity to buy a Medicare Supplement insurance plan is during your Medigap Open Enrollment Period. This six-month period begins the month you’re both enrolled in Medicare Part B and 65 years old or greater. If you sign up for a Medigap plan during this period, you have a guaranteed issue right to buy the policy without undergoing medical underwriting or paying a higher premium because of a health problem. Once your Medigap Open Enrollment Period has ended, in most cases you don’t have guaranteed issue rights. There are some other situations where you may have guaranteed issue rights.
Besides buying a Medicare Supplement insurance plan during a time when you may have guaranteed issue rights, the following factors might affect the cost of a Medigap plan.
Please note that not every type of Medigap insurance plan or discount will be available in every state or from every insurance company that offers Medigap plans.
This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.
eHealth's Medicare website is operated by eHealthInsurance Services, Inc., a licensed health insurance agency doing business as eHealth. The purpose of this site is the solicitation of insurance. Contact may be made by an insurance agent/producer or insurance company. eHealth and Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. We offer plans from a number of insurance companies.