A Working Checklist for Medigap Policies
Medigap Policies: what is worth doing, what is worth avoiding, and when to stop and see a doctor.
Medicare Supplement Insurance sold by private companies to help pay costs that Original Medicare does not, such as copays, coinsurance and deductibles. Original Medicare has no yearly out-of-pocket limit, so a Medigap policy can protect against large bills, but the best time to buy one is limited.
Key takeaways
- Works with: Original Medicare only, not Medicare Advantage
- Standard plans: identified by letters; the same letter gives the same basic benefits in most states
- Most useful single change: Buy during your Medigap Open Enrollment Period if you want a policy.
- Commonest mistake: Buying Medigap if you are in a Medicare Advantage plan.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
Do
- Buy during your Medigap Open Enrollment Period if you want a policy
- Compare prices for the same lettered plan from several companies
- Pair Medigap with a separate Part D plan for drug coverage
- Ask your State Health Insurance Assistance Program (SHIP) about your state's rules
Do not
- Buying Medigap if you are in a Medicare Advantage plan
- Assuming you can buy Medigap later without medical questions
- Choosing on premium alone without asking how prices rise with age
The numbers behind the list
The list is built from the numbers below, which come from the bodies cited at the end.
| Measure | Figure |
|---|---|
| Works with | Original Medicare only, not Medicare Advantage |
| Standard plans | identified by letters; the same letter gives the same basic benefits in most states |
| Medigap Open Enrollment Period | 6 months, starting the first month you have Part B and are 65 or older |
| During that period | companies cannot deny you or charge more because of health problems |
| Drug coverage | Medigap plans sold today do not include prescription drug coverage |
| Plans C and F | not available to people newly eligible for Medicare on or after January 1, 2020 |
If you change one thing
Buy during your Medigap Open Enrollment Period if you want a policy. Start there. The rest of the list keeps.
Related topics
- Premiums, Deductibles and Copays: What the Evidence Actually Says (Health Insurance and Costs)
- The Evidence on Travel Insurance and Healthcare Abroad, Without the Hype (Travel Health)
- What the Guidance Really Says About Benefits and Financial Support (Long-Term Conditions)
- The Evidence on Getting a Referral and Prior Authorization, Without the Hype (Using Health Services)
Where to go next
- Medigap Policies, Explained Without the Jargon
- Popular Beliefs About Medigap Policies, and What Is Actually Published
- Medigap Policies — the reference entry
- Medicare and Medicaid: The Complete Guide
- Medicaid Eligibility: Sorting the Evidence From the Noise
- CHIP Coverage for Children: What the Evidence Actually Says
When to speak to a doctor
Get advice before dropping a Medigap policy, since you may not be able to get it back. Call 911 for any medical emergency; coverage questions can wait.
Where this comes from
- Medicare.gov — What's Medicare Supplement Insurance (Medigap)?
- Medicare.gov — When can I buy Medigap?
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.
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