What is Medigap? An Overview of Medicare Supplemental Insurance

Medigap is a type of health insurance for seniors designed to bridge the coverage gaps left by standard Medicare benefits. Offered by private insurance companies, it's a supplemental health insurance that works in addition to your Original Medicare Plan to pay for certain services not covered by Medicare.

Most insurance companies sell "standardized" Medigap policies. Strict federal regulations ensure that each policy, referred to by letters A through L, offer the same benefits whether that policy is in California or Connecticut. Because of the standardization of Medigap plans, the greatest difference you're likely to find between any two insurance companies is price. Each Medicare senior supplemental insurance policy covers only one person, so if both you and your partner need coverage, you'll need to buy two separate policies.

The Medigap policy letters on offer may vary from state to state. Although private health insurance companies can offer only standardized Medigap policies, there are exceptions in Massachusetts, Wisconson, and Minnesota. A few states offer a Medigap policy called Medicare SELECT. Medicare SELECT is a lower-cost option which requires you to use specific hospitals, or in some cases, specific doctors, in order to have the costs covered by your Medigap policy.

Although Medigap policies are sold by private insurance companies, they are strictly regulated by federal and state law. Legitimate policies must be clearly identified as "Medicare Supplement Insurance".

What Medigap is Not

Medigap is not a Medicare Health Plan or a vehicle for receiving Medicare benefits. It is intended as a separate, supplemental health insurance policy that works alongside the Original Medicare Plan to provide increased health care benefits.

What Medigap Covers

Medigap covers a range of co-insurance and deductible payments not covered by Medicare. Medigap Plans A through L offer a range of increased coverage benefits, ranging from deductibles and excess charges for Medicare Parts A and B, to Hospice care co-insurance or co-payment, to co-insurance for skilled nursing facility care. What Medigap Does Not Cover

Supplemental health insurance policies cover many, but not all, of Medicare's insurance gaps. Medigap does not cover: long-term care (for example, nursing homes or private home care), hearing aids, dental or vision care, or eyeglasses, although some insurance companies may offer extra benefits along with your Medicare supplemental insurance policy for seniors.

Medigap also does not cover prescription medication costs. If you need greater prescription medication coverage, Medicare now offers drug plans for all members through insurance companies and privately-owned companies. You can add prescription drug coverage to your Medicare plan by either 1) adding a Medicare Prescription Drug Plan (sometimes called "PDP's") to your Original Medicare Plan, or by 2) joining a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug benefits.

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