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Medigap Insurance: Extra Help with Your Health Care Costs

Harleysville, Perkasie, Philadelphia & All of Southeastern Pennsylvaniaimage of medicare enrollment form


Medigap Insurance Quote

Millions of Americans use the government’s Medicare program as their source of health insurance. It makes health insurance affordable for seniors and others who rely on it to cover their medical costs.

Still, Medicare alone won’t cover 100% of your costs of care. For extra help, qualifying individuals can enroll in a private Medicare Supplemental, also known as a Medigap plan.

What is Medigap insurance?

Original Medicare is the health insurance program begun by the government several decades ago. Most taxpayers qualify for this program, usually around the time they turn 65 years old. Therefore, once you enroll in coverage, you’ll be able to receive covered health care services, paid by Medicare.

However, Original Medicare comes with costs that participants must pay themselves. For extra assistance, many private insurers offer supplementary insurance policies to help defray some of that cost burden. Medigap plans are one of the options that can help you cover these costs.

How can Medigap plans help me save money?

By buying a Medigap plan, you can receive additional help paying some of the outstanding costs left by Original coverage.

Plans exist because, though Original Medicare can help you pay for medical costs—hospitalizations, surgeries, checkups, lab work—they still will have costs attached. For example, deductibles and co-payments might apply. Rather than paying out-of-pocket for such costs, you can use your Medigap plan.

Keep in mind, you will still have to pay a premium for this plan, and plans will only cover one person. Spouses will need separate policies.

What will my plan cover?

Medigap plans usually can help you pay costs related to your Original Medicare, like:

  • Coinsurance
  • Copayments
  • Deductibles

So, if you have surgery, and have coinsurance on the procedure, this plan might pay that cost, at least in-part and possibly in-full. Therefore, you’ll have less of a personal burden for health care costs.

Who is eligible for Medigap?

To qualify for Medigap plans, you usually must first qualify for and enroll in Original Medicare. Requirements to get Original Medicare may include:

  • You are age 65 or older
  • You have end-stage renal disease (ESRD) or Lou Gehrig’s Disease (ALS)
  • You have a disability, and receive benefits from Social Security or the Railroad Retirement Board

However, because Medigap plans are private plans, other rules on enrollment may apply. For example, some insurers will not offer plans to those under age 65. Talk to your Medigap agent about your own eligibility for coverage.

Can I buy Medigap insurance at any time?

You can apply for a Medigap plan as soon as you enroll in Medicare Parts A & B. However, the best time to apply is during your Medicare Supplement Open Enrollment period. This is a six-month period that starts on the first day of the month that you are both age 65 or older and have Medicare Part B.


Medigap Insurance Quote

Medigap vs. Medicare Advantage

Medicare Advantage plans are another type of private health insurance. They provide all the benefits of Medicare Part A & Part B, but also might cover other care, like prescription drugs, dental and vision.

What is the difference between Medigap and Medicare Advantage plans?

In a way, Medicare Advantage plans take the place of an Original Medicare plan, though you remain in the Medicare program if you get this plan. It will help you cover services not covered by Original Medicare, along with a different pricing structure.

Medigap plans simply help you pay outstanding costs after your Original coverage pays. Therefore, they usually won’t provide coverage for any additional services.

Do you need Medigap with Medicare Advantage?

Usually, you cannot buy both Medigap and Medicare Advantage plans. You must choose between them.

Is it better to have Medicare Advantage or Medigap?

We can help you determine whether a Medigap plan or Medicare Advantage coverage is a better option for you. Often, determining the better plan depends on what types of care you need, as well as your financial goals.