Medicare Supplements
Medicare Supplement (Medigap) policies can help cover certain out-of-pocket costs that Original Medicare doesn’t pay—so you can focus on care with fewer surprise expenses.
Medicare Supplement Insurance
Understand what Medigap can help cover.
Original Medicare does not pay every healthcare expense. Medigap is private insurance that helps pay certain remaining costs—giving you another way to plan for what you may owe.
What it may help pay
- Coinsurance: A percentage of covered service costs.
- Copayments: Fixed amounts for certain covered services.
- Deductibles: Specified deductibles covered by your policy.
Benefits differ by policy. Medigap does not cover every expense or every service that Original Medicare excludes.
How it works
You generally need Medicare Parts A and B. Original Medicare pays its share of covered services first; Medigap then pays according to the policy’s benefits.
Medigap is separate from Medicare Advantage and does not pay a Medicare Advantage plan’s deductibles or copayments.
Explore official Medigap basicsEight things to know before choosing.
Look at the coverage, cost, and enrollment rules together.
It supplements Original Medicare.
Medigap works alongside Parts A and B. It is not a replacement for Medicare and cannot be used to supplement Medicare Advantage, including a Medicare Medical Savings Account plan.
Compare the same policy type.
In most states, standardized policies use plan letters. Basic benefits for the same letter are standardized, while premiums differ. Massachusetts, Minnesota, and Wisconsin standardize policies differently.
Budget for separate premiums.
You pay a Medigap premium in addition to your Part B premium and any other applicable premiums. Ask how the policy is priced and how premiums may change over time.
Each person needs a policy.
A Medigap policy covers one person. Spouses who both want Medigap need separate policies and may choose different coverage based on their needs.
Provider access is generally broad.
Standard Medigap policies generally work with providers accepting Medicare nationwide. Medicare SELECT policies can have network requirements for certain benefits.
New policies do not include Part D.
Medigap policies sold after 2005 do not include prescription drug coverage. Review whether a separate Part D plan is appropriate for your prescription coverage needs.
Renewability does not freeze premiums.
Standardized Medigap policies are guaranteed renewable. The insurer cannot cancel solely because your health worsens if you pay premiums. Premiums can still increase, and other legal cancellation exceptions may apply.
Eligibility and timing affect your choices.
A company must be licensed to sell Medigap in your state. Whether it must accept your application depends on enrollment protections, eligibility, and state rules.
Understand your enrollment protections.
Medigap enrollment follows different rules from Medicare’s annual health and drug plan enrollment periods.
Your six-month enrollment period
The federal Medigap Open Enrollment Period starts the first month you are 65 or older and enrolled in Part B. During this period, insurers cannot use your health to deny a policy they offer or charge you more.
A waiting period for coverage of certain pre-existing conditions may still apply.
Buying coverage later
Outside open enrollment, medical underwriting may apply unless you have a guaranteed issue right or another protection. State law may provide additional opportunities.
Federal rules generally do not require insurers to sell Medigap to people under 65. Check your state’s protections.
Other coverage is not the same as Medigap.
These programs and policies serve different purposes and may have their own coordination rules.
Medicare Advantage, Part D & Medicaid
Medicare Advantage: A private-plan alternative for receiving Medicare benefits. It is not Medigap.
Part D: Prescription drug coverage. It does not replace Medigap’s medical cost-sharing benefits.
Medicaid: A separate federal and state program for eligible people. Ask how existing Medicaid benefits affect the need for, and ability to purchase, Medigap.
Employer, union, federal & military benefits
Employer and union plans, the Federal Employees Health Benefits program, TRICARE, and VA benefits are not Medigap. Each has its own rules.
Before changing coverage, ask the responsible benefits administrator how the change would affect you and any dependents.
Long-term care insurance
Long-term care insurance addresses qualifying care needs under its own policy terms. Medigap generally does not cover ongoing custodial long-term care.
Review your options before dropping a policy.
Ending coverage and getting it back later are separate decisions.
- Original Medicare continues: Dropping Medigap does not cancel Parts A and B.
- Your share of costs can change: You may become responsible for expenses the policy previously paid.
- Reapplying may involve underwriting: Acceptance and pricing may depend on your health unless protections apply.
- Confirm any guaranteed issue rights: These have specific eligibility rules, policy choices, and deadlines.
- Coordinate effective dates: Verify replacement coverage and timing before canceling an existing policy.
Let’s talk through your questions.
Contact David Anderson at Certified Financial Group, LLC to discuss your priorities and how healthcare costs fit into your retirement planning.
Educational information: Benefits, availability, premiums, and enrollment rights vary by policy, state, and individual circumstances. Review policy documents and confirm eligibility before enrolling or changing coverage. Certified Financial Group, LLC is not affiliated with or endorsed by Medicare or any government agency. External links open in a new tab.