medigap basics
Medicare Supplement Insurance (Medigap) is extra insurance you can buy from a private insurance company to pay your share of out-of-pocket costs in Original Medicare, minus the annual deductible.
You get a 6 month “Medigap Open Enrollment” period, which starts the first month you have Medicare Part B and you’re 65 or older. During this time, you can enroll in any Medigap policy and the insurance company can’t deny you coverage due to pre-existing health problems. After this period, you may not be able to buy a Medigap policy, or it may cost more. Your Medigap Open Enrollment Period is a one-time enrollment. It doesn’t repeat every year, like the Medicare Open Enrollment Period.
All Medigap policies are standardized. This means, policies with the same letter offer the same basic benefits no matter where you live or which insurance company you buy the policy from. There are different types of Medigap supplemental plans offered in most states, which are named by letters: F, G, and K-N. Price is the only difference between plans with the same letter that are sold by different insurance companies.
Every Medigap policy must follow federal and state laws designed to protect you.
Medicare Supplement Insurance (Medigap) is extra insurance you can buy from a private insurance company to pay your share of out-of-pocket costs in Original Medicare, minus the annual deductible.
You get a 6 month “Medigap Open Enrollment” period, which starts the first month you have Medicare Part B and you’re 65 or older. During this time, you can enroll in any Medigap policy and the insurance company can’t deny you coverage due to pre-existing health problems. After this period, you may not be able to buy a Medigap policy, or it may cost more. Your Medigap Open Enrollment Period is a one-time enrollment. It doesn’t repeat every year, like the Medicare Open Enrollment Period.
All Medigap policies are standardized. This means, policies with the same letter offer the same basic benefits no matter where you live or which insurance company you buy the policy from. There are different types of Medigap supplemental plans offered in most states, which are named by letters: F, G, and K-N. Price is the only difference between plans with the same letter that are sold by different insurance companies.
Every Medigap policy must follow federal and state laws designed to protect you.
how it works
If you have a Medigap policy and get care, Medicare will pay its share of the Medicare-approved amount for covered health care costs. In most Medigap policies, you agree to have the Medigap insurance company get your Part B claim information directly from Medicare. Then, your Medigap policy will pay your doctor whatever amount you owe under your policy. Some Medigap insurance companies also provide this service for Part A claims.
Once you buy a policy, you'll keep it as long as you pay your Medigap premiums. All standardized Medigap policies are automatically renewed every year, even if you have health problems. Your Medigap insurance company can only drop you if:
What's Covered? Medigap policies help cover out-of-pocket costs associated in Original Medicare, like: Some Medigap policies cover services that Original Medicare doesn't cover, like emergency medical care when you travel outside the U.S. (foreign travel emergency care).
What's not covered?
Medigap doesn’t cover everything. Medigap plans generally don’t cover:
Once you buy a policy, you'll keep it as long as you pay your Medigap premiums. All standardized Medigap policies are automatically renewed every year, even if you have health problems. Your Medigap insurance company can only drop you if:
- You stop paying your premiums
- You weren't truthful on the Medigap policy application
- The insurance company goes bankrupt or goes out of business
What's Covered? Medigap policies help cover out-of-pocket costs associated in Original Medicare, like: Some Medigap policies cover services that Original Medicare doesn't cover, like emergency medical care when you travel outside the U.S. (foreign travel emergency care).
What's not covered?
Medigap doesn’t cover everything. Medigap plans generally don’t cover:
- Long-term care (like care in a nursing home)
- Vision or dental care
- Hearing aids
- Eyeglasses
- Private-duty nursing
Part D coverage
How to get prescription drug coverageMedicare drug coverage helps pay for prescription drugs you need. It's optional and offered to everyone with Medicare. Even if you don’t take prescription drugs now, consider getting Medicare drug coverage. If you decide not to get it when you’re first eligible, and you don’t have other creditable prescription drug coverage (like drug coverage from an employer or union) or get Extra Help, you’ll likely pay a late enrollment penalty if you join a plan later. Generally, you’ll pay this penalty for as long as you have Medicare drug coverage. To get Medicare drug coverage, you must join a Medicare-approved plan that offers drug coverage. Each plan can vary in cost and specific drugs covered.
There are 2 ways to get Medicare drug coverage:Medicare drug plans. These plans add drug coverage to Original Medicare, some Medicare Cost Plans, some Private Fee‑for‑Service plans, and Medical Savings Account plans. You must have
Remember, you must have Part A and Part B to join a Medicare Advantage Plan, and not all of these plans offer drug coverage.
To join a Medicare drug plan, Medicare Advantage Plan, or other Medicare health plan with drug coverage, you must be a United States citizen or lawfully present in the United States.
How to join a drug planOnce you choose a Medicare drug plan, here's how to get prescription drug coverage:
There are 2 ways to get Medicare drug coverage:Medicare drug plans. These plans add drug coverage to Original Medicare, some Medicare Cost Plans, some Private Fee‑for‑Service plans, and Medical Savings Account plans. You must have
Remember, you must have Part A and Part B to join a Medicare Advantage Plan, and not all of these plans offer drug coverage.
To join a Medicare drug plan, Medicare Advantage Plan, or other Medicare health plan with drug coverage, you must be a United States citizen or lawfully present in the United States.
How to join a drug planOnce you choose a Medicare drug plan, here's how to get prescription drug coverage:
- Enroll on the Medicare Plan Finder or on the plan's website.
- Complete a paper enrollment form.
- Call the plan.
- Have us do it for you! 973-300-5433 or click the link above to schedule
Important Notices:
*We may not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Visit cms.gov and click on Medicare for more information.
*Any information provided on this website regarding Medicare, is provided as a courtesy by a Licensed Sales Agent certified to provide Medicare products to clients.
*We are not a government entity, nor a non-profit agency.
*Our services are free of charge to our clients, but we may receive compensation from individual insurance carriers for our services.
*We may not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Visit cms.gov and click on Medicare for more information.
*Any information provided on this website regarding Medicare, is provided as a courtesy by a Licensed Sales Agent certified to provide Medicare products to clients.
*We are not a government entity, nor a non-profit agency.
*Our services are free of charge to our clients, but we may receive compensation from individual insurance carriers for our services.
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