Medicare Supplement (Medigap) Frequently Asked Questions

Medicare Supplement (Medigap) FAQ

Do I necessarily need Medicare Supplemental Insurance?
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Medicare Supplemental Insurance is designed to pick up the costs not covered by existing Medicare coverage. Hence, the name “Medigap” — it fills in the gaps in coverage. It’s not required or even essential, but many people find it helpful when faced with unexpected healthcare expenses.

What are the requirements?
You must already have Medicare Part A and Medicare Part B plane and continue paying your Part B premium and then pay a premium to the Medigap provider. Some Medigap providers require a medical screening and/or an attending physician’s written statement regarding your health.

Are Medigap policies the same everywhere?
Generally, plans are standardized but since Medigap is private insurance and not government sponsored, the rules governing the sale and offerings of a Medigap insurance policy can vary from state to state. Some states such as Massachusetts, Minnesota, and Wisconsin require Medigap insurance to provide additional coverage than what is defined in the standardized Medigap plans.

Are prescription drugs covered by Medigap Insurance?

Some Medigap policies sold before January 1, 2006 may include prescription drug coverage, but after that date no new Medigap policies could be sold with drug coverage. At that time, Medicare Part D (Prescription Drug Coverage) was introduced.

Is Medigap coverage standardized as far as benefits?
There are 12 different standardized plans, each sold by private companies in different combinations. An individual’s Medigap coverage is in line with the amount of plans chosen and premium paid. It’s essentially an a la carte approach to filling in the gaps.

Can I purchase additional Medigap coverage for my spouse?
Medigap coverage is for the individual only.





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