A Medigap plan (also called a Medicare Supplement), sold by private companies, can help pay some of the health care costs Original Medicaredoesn't cover, like copayments, coinsurance and deductibles.
Some Medigap plans also offer coverage for services that Original Medicare doesn't cover, like medical carewhen you travel outside the U.S. If you have Original Medicare and you buy a Medigap plan, Medicare will pay its share of theMedicare-approved amountfor covered health care costs. Then your Medigap planpays its share.
What are the differences between Medigap and Medicare Advantage plans?
A Medigap plan is different from aMedicare Advantage (MA) plan (PDF, 107KB). MA plans are a way to get Medicarebenefits, while a Medigap only supplements your Original Medicare benefits.
Medigap plans | Medicare Advantage plans | |
|---|---|---|
Premium costs | Higher premiums | Lower premiums |
Out-of-pocket costs | Fewer out-of-pocket costs | More out-of-pocket costs |
Where you can get care | Works in any state | Works only in your state, by region |
Provider network | Don't need a provider network (unless you buy a Medigap Select plan) | Must use a provider network |
Prescription drugs (Part D) | Medicare Part D not included | Medicare Part D usually included |
Things to consider before you buy a plan
- You must have Medicare Part A and Part B.
- If you have a Medicare Advantage (MA) plan, you can apply for a Medigap policy, but make sure you leave the MA plan before your Medigap plan starts.
- You pay the private insurance company a monthly premium for your Medigap plan in addition to the monthly Part B premium you pay to Medicare.
- A Medigap plan only covers one person. If you and your spouse both want Medigap coverage, you'll each have to buy separate policies.
- You can buy a Medigap plan from any insurance company that's licensed in your state to sell one.
- Any standardized Medigap plan is guaranteed renewable even if you have health problems. This means the insurance company can't cancel your Medigap plan as long as you pay the premium.
