Medigap (Medicare Supplement Insurance) Policies

The Original Medicare Plan pays for many health care services and supplies, but it doesn't pay all of your health care costs or cover prescription drugs. To help cover extra health care costs, you might want to get a Medigap policy.

A Medigap policy is a health insurance policy sold by a private insurance company. They must follow federal and state laws. These laws protect you. The front of the Medigap policy must clearly identify it as "Medicare Supplement Insurance."

Costs that you must pay, like coinsurance, co-payments, and deductibles, are called "gaps" in Original Medicare Plan coverage. You might want to consider buying a Medigap policy to cover these gaps in Original Medicare coverage. Some Medigap policies also cover benefits that the Original Medicare Plan doesn’t cover, like emergency health care while traveling outside the United States. A Medigap policy may help you save on out-of-pocket costs. If you buy a Medigap policy, you will pay a monthly premium to the private insurance company that sells you the policy.

In all states except Massachusetts, Minnesota, and Wisconsin, a Medigap policy must be one of 12 standardized policies (Plans A–L) so you can compare them easily. Each plan has a different set of benefits. Plans K and L are newer policies that help limit high out-of-pocket costs for doctor’s services and hospital care and are available in various parts of the country. They likely have a lower premium than other Medigap policies. However, unlike Plans A–J, you will pay more of Medicare’s coinsurance and deductibles before the policy pays its share of these costs.

Two of the standardized policies (Plans F and J) may have a high-deductible option. In addition, any standardized policy may be sold as a "Medicare SELECT" policy. Medicare SELECT policies usually cost less because you must use specific hospitals and, in some cases, specific doctors to get full insurance benefits from the policy. In an emergency, you may use any doctor or hospital.