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Health Works Collective > Policy & Law > Health care > What Is Medicare Supplement Insurance?
Health carePublic Health

What Is Medicare Supplement Insurance?

Sean Mallon
Last updated: October 14, 2021 5:07 am
Sean Mallon
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Medicare supplement insurance is a type of insurance that is designed to cover the expenses that are not covered by Medicare. It is also referred to as Medigap. Many people who have Medicare are surprised to find out that Part B will only cover about 80 percent of their medical expenses. If you are living on a tight budget, then the 20 percent can create a major problem for you. Fortunately, Medicare insurance can pay for the remaining expenses.

Contents
Am I Eligible for Medicare Supplement Insurance?Is There Anything That Is Not Covered By Medigap?

Am I Eligible for Medicare Supplement Insurance?

You need to have Medicare Part A and Part B in order to get Medigap insurance. It is also important to note that there is a difference between a Medigap policy and Medicare Advantage plan. A Medicare advantage plan is a type of Medicare plan that you get from a private company instead of the government. Medigap is designed to supplement an existing Medicare insurance plan.

You will have to pay a private insurance company for your Medigap plan or go through medicare broker like Medicareusa. You will have a premium that you will have to pay each month. You will have to buy from a company in your state. A Medigap plan will only cover one person. If you are married, then your spouse will need their own separate plan.

Keep in mind that you cannot have a Medigap plan if you have a Medicare advantage plan. However, you can get a Medigap plan if you switch back to original Medicare.

How a Medigap Plan Works

Your doctor will send you a bill for the services that have been provided. Medicare will pay their portion. Medigap will pay the remaining balance.

The Benefits of Using a Medicare Supplement Plan

  • You are free to choose your own hospitals and doctors.
  • You won’t have to get a referral to see a specialist.
  • Your out-of-pocket expenses will be more predictable.
  • You will be able to use it anywhere in the United States.
  • You won’t have to worry about getting your coverage dropped if you develop a health condition.

Is There Anything That Is Not Covered By Medigap?

Medigap will cover your hospital expenses, doctor’s bills and medications. However, there are some things that will not be covered. This includes long-term care, such as assisted living, nursing home and home care. Vision care, dental care and hearing aids also aren’t covered.

The Cost of Medicare Supplemental Insurance

Because you get Medicare supplemental insurance through a private company, the cost of it can vary. You may have to shop around to find a premium that fits your budget. Insurance companies offer the following pricing structures.

Community No-Age-Rated

The insurance company will charge the same rate across the board.

Issue Age-Rated

Your premium will be based on the age that you are when you first enroll. The younger you are when you enroll, the more money you will be able to save.

Attained-Age-Rated

The age you are when you first enroll will determine your premium. However, you will have to pay more for your insurance as you get older.

Will I Be Able to Change My Medicare Supplement Plan Any Time?

You can make a change to your plan any time. However, it is a good idea for you to wait until the enrollment period. You will have to answer any questions about your health if you attempt to change the plan outside of the enrollment period. The company can choose to accept or decline you.

However, there are some states that have exceptions to this. Washington, California, Oregon and Connecticut have established exceptions.

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