Illinois Medicare Supplemental Insurance (Medigap)

Medicare supplemental insurance plans (also called Medigap plans) in Illinois are sold through private insurance companies, and regulated through the Illinois Department of Insurance. Medigap policies are supplemental health insurance policies that fill in the coverage gaps of what Medicare does not pay, such as deductibles for Medicare Part B.

There are twelve standardized Medigap policies for seniors (age 65 and better), and insurance companies are able to offer all twelve. However, they may choose to offer any plans they choose, and most companies don't offer all twelve policies. The Medigap policies available for seniors in Illinois are: Plans A-L, and high-deductible Plans F, J, K, and L, which offer the same benefits as the regular versions of these Plans, but with lower monthly premiums and higher deductibles.

Seniors in Illinois benefit from the "open enrollment period" for Medicare supplemental insurance. During your open enrollment period, Medigap insurance companies are required by law to sell you a Medigap policy if you are at least age 65 and apply for a policy within the first six months after enrolling in Medicare Part B. However, the insurance company may require you to wait for up to six months to receive Medigap coverage for pre-existing medical conditions, even if you apply during your open enrollment period.

Additionally, during the six months of your open enrollment period, you have the right to sign up for a Medicare supplemental insurance policy, then cancel that policy or change to a different policy if you don't like the first one.

Outside of the open enrollment period, Illinois seniors can take advantage of the "free look" policy when applying for Medigap plans. Your "free look" period is the 30 days after you enroll in a Medigap plan, during which you are allowed to cancel your policy and have your premium refunded if you decide you don't want the Medigap plan.

Not everyone needs Medicare supplemental health insurance. You probably don't need it if you belong to a Medicare Advantage Plan, if you're enrolled with Medicaid in Illinois, or if the Qualified Medicare Beneficiary (QMB) program pays your Medicare costs, including out-of-pocket expenses for Medicare's coverage gaps.

You can learn about a Medigap insurance company's complaint record and financial rating through the Illinois Senior Health Insurance Program (SHIP) or the Office of Consumer Health Insurance (OCHI).