Medicare Supplement

What is Medicare Supplement insurance?

Medigap is private insurance that helps pay some of the health care costs Original Medicare does not pay, such as coinsurance, copayments, and deductibles.

How a Medigap policy works

1

You receive care

You visit any provider in the United States that accepts Medicare assignment.

2

Medicare pays first

Original Medicare processes the claim and pays its approved share.

3

Your Medigap plan pays

The supplement pays the eligible remaining costs its plan letter covers.

4

You pay what's left

Typically your deductible, any plan copays, and services Medicare does not cover.

Standardization, premiums, and underwriting

Three ideas that explain most of what people find confusing about Medigap.

Standardized benefits

In most states, each plan letter has a benefit set defined by federal standards. Massachusetts, Minnesota, and Wisconsin standardize differently.

Premiums vary

Carriers set their own rates and rating method — attained age, issue age, or community rated — so identical benefits can carry very different premiums and rate histories.

Underwriting

During your Medigap open enrollment period, or in a guaranteed issue situation, health questions generally do not apply. Outside those windows, carriers may use medical underwriting to decide on an application.

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