One question that is asked of CHOICES counselors is: “What is a medigap policy?”
Medigaps insurance policies work with Original Medicare to pay some of the remaining costs after Medicare pays its portion of a health care charge. As you know, Medicare doesn’t cover all the costs of health care. There are deductibles, coinsurance, and copayments that you are responsible for after Medicare pays its portion of covered expenses. The policies are standardized policies, sold by private insurance companies. Remember, Medigaps only work with Original Medicare. If you have a Medicare Advantage plan, you cannot buy a Medigap and you may not need one, depending on your individual needs and the coverage of your Medicare Advantage Plan.
There are 10 different Medigap policies you can purchase. Each is standardized meaning that each one in a particular category provides the exact same coverage no matter which insurance company you select. The companies are different but each policy in the same standardized category is exactly the same across companies. That means that as a consumer, you need to determine what you need and want from an insurance policy and then examine the materials from each company to see which company that provides the services you need offers the best deal for that policy. You will find premiums across plans can vary significantly.
There are protections in place to prevent companies from discriminating against you based on health status, but there are also limits on the sale of policies that companies can impose that impact when and whether you can purchase a Medigap policy. It is important for you to be informed about your rights and requirements. You cannot purchase a Medigap policy if you are enrolled in a Medicare Advantage plan.
If you need assistance understanding Medigap policies, call CHOICES, your source for accurate, independent information about Medicare and related insurances. 1.800.994.9422