Medicare Supplement Basics


Medicare Supplement Insurance (often called Medigap Insurance) is health insurance sold by private insurance companies to fill “gaps” and costs not covered by Original Medicare. Medigap policies help pay your share (coinsurance, copayments, deductibles, etc.) of the costs associated with Medicare-covered services. Medicare may cover many health care services and supplies, however it was never intended to cover ALL your health care costs. In fact, the average person could end up spending thousands per year out of their own pocket…which is why many Medicare beneficiaries choose a Medicare Supplement Insurance plan.

Insurance companies can only sell you a “standardized” Medigap policy. This means that all Medigap policies sold by the various companies have specific benefits, so you can compare them easily. Medigap policies must follow Federal and state laws. These laws are developed protect you, for example the front of a Medigap policy must clearly identify it as “Medicare Supplement Insurance.”

Cost is usually the only difference between Medigap policies sold by different insurance companies. Since costs can vary from company to company, it is very important to compare and receive quotes from multiple companies.

Medicare SELECT is a type of Medigap policy that is sold in some states and may require you to use hospitals and, in some cases, doctors within its network to be eligible for full insurance benefi ts (except in the case of an emergency). Medicare SELECT can be any of the standardized Medigap plans and generally cost less than traditional Medigap policies. Note, if you do not use a Medicare SELECT hospital or doctor for non-emergency services, you will have to pay some or all of what Medicare does not pay. Medicare will pay its share of approved charges no matter which hospital or doctor you choose.

Generally, when you buy a Medigap policy you must have Medicare Part A and Part B. You will have to pay the monthly Medicare Part B premium. In addition, you will have to pay a premium to the Medigap insurance company. As long as you pay your premium, your Medigap policy is guaranteed renewable. This means it is automatically renewed each year. Your coverage will continue year after year as long as you pay your premium.

You are guaranteed the right to buy a Medigap policy under certain circumstances. You and your spouse must buy separate Medigap policies. Your Medigap policy won’t cover any health care costs for your spouse. Some Medigap policies also cover other extra benefits that aren’t covered by Medicare.

Most of the information above is taken from the publication “Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare”, published by the Centers for Medicare & Medicaid Services (CMS).  CMS is the federal agency responsible for administering the Medicare, Medicaid and several other health-related programs.