Understanding the Basics of Medigaps

How does Medicare Supplement Insurance (Medigap) work? The costs that Medigaps cover include deductibles, coinsurance amounts, and copays that your Original Medicare does not cover. For example, a Medigap pays for your Part B coinsurance charges, meaning that it will pay for the 20% coinsurance you normally owe when you receive Medicare-covered physicians’ services. It will also pay for the deductibles and the copays on your Part A hospitalization.

It is important to know that Medigap policies only work with Original Medicare Parts A and B. If you get your Medicare benefits from a Medicare Part C plan known as a Medicare Advantage Plan, you cannot purchase a Medigap. Medigaps only pay for Original Medicare cost-sharing gaps.

Medigap policies must follow federal and state laws designed to protect you, and they must be clearly identified as “Medicare Supplement Insurance.” Insurance companies can sell you only “standardized” plans, which are named by most states by letters of the alphabet A-D, F, G, and K-N. All the plans with the same letter offer the same basic benefits, regardless of where you live or which insurance company you buy the plan from. That’s why you can benefit from shopping around.

Contact your State Health Insurance Assistance Program – called “SHIP” – to learn more about how to compare Medigap policy coverages. If you have any questions, please call Lynn, the SHIP counselor at the DeKalb County Council on Aging at 256-845-8590.