is reader-supported. When you buy through links on our site, we may earn an affiliate commission. Learn more

What You Need to Know About Choosing a Medigap Policy

Nearly one out of every five Americans currently don’t have any form of health insurance.

But even if you are insured, are you certain your policy provides you with all the coverage you need? Or, are there health and medical issues (like vision and dental care) you often end up paying for out of pocket?

If you’re on Medicare, then you’ve likely heard of the corresponding Medigap policies. But what are these policies and how will they benefit you?

Most of all, what are the things you should keep in mind when choosing a Medigap policy? Keep on reading this post to find out.

What Is a Medigap Policy?

Before we get into choosing a Medigap policy, let’s make sure you know what one actually is.

A Medigap plan is a type of supplemental insurance plan that fills in the “gaps” in your overall Medicare policy. You’ll buy a Medigap plan from a private health insurance company and will pay a premium each month for this coverage.

Remember you can only get a Medigap policy if you have Medicare Part A and Part B. If you’re currently enrolled in a Medicare Advantage plan, you’re not eligible to apply for a Medigap plan. Usually, this supplemental coverage will help you to pay for things like insurance deductibles, co-pays, and even health care you might need outside of the United States.

Be aware that Medigap plans won’t usually help with coverage for vision and dental care, hearing aids, or prescription medication. So, you might consider additional supplemental coverage (or a plan outside of Medicare) if you need coverage for those issues.

Now, let’s take a look at some tips you should consider when choosing a Medigap policy.

1. Remember the Lack of Ratings

Although it’s fairly easy for you to find lots of ratings for different Medicare Advantage policies, the same can’t be said for Medigap plans.

This is because the type of coverage you get under a specific Medigap policy is the same, no matter who you decide to purchase that policy from. This is why it’s usually a smart idea to look into discount coverage providers before going with a more expensive provider.

Plus, specific Medigap rules will vary from state to state, according to unique consumer protection laws. This makes it even tougher to provide a blanket rating for a Medigap policy.

2. Understand the Pricing Structure

When you’re choosing a Medigap policy, it can sometimes be a bit of a challenge to figure out the pricing structure.

For example, you might opt for a community-rated pricing structure. This means that, whether or not you’re over the age of 65, everyone who has a community-rated price will pay the same premiums.

They might not be the cheapest option when you first buy them, but they’re the most affordable over time.

You could also choose an issue-age-related premium, which is calculated according to the age you are when you purchase your Medigap plan. Inflation, not your age, will cause costs to increase.

Finally, you might go with an attained-age-rated premium, which is affordable at the start, but increases as you age.

3. Consider Pre-Existing Conditions

You also need to know how your pre-existing conditions might impact your Medigap coverage and eligibility.

You will have a grace period, called a “guaranteed issue” period allowing you to buy a Medigap plan within six months of your 65th birthday. You cannot get denied coverage or charged more for coverage because of a pre-existing condition if you enroll during this six month period.

That’s why it’s so important to be proactive and to start thinking about the Medigap policy which will work for you as soon as possible. Afterward, you could get charged more or turned down.

4. Get to Know the Different Plans

There are ten different Medigap plans you can choose from. Each plan picks up a different level of expenses, with the premiums rising according to how much the plan will cover.

These expenses can include hospice care, emergency care outside of the United States, your deductible and excess charges, and even the costs of nursing facilities.

Different Medigap policies will also help you to pay for hospital co-payments and deductibles, lab and x-ray services, medical equipment needed, and even pints of blood.

The most popular Medigap Plan is Plan F, although opting for Plan G is an excellent way to help you to save.

Be aware, however, that if you live in Wisconsin, Minnesota, or Massachusetts, you’re subject to different regulations surrounding a Medigap policy.

We suggest you get in touch with your State Insurance Department directly to help you better understand your eligibility and options if you live in one of these three states.

Wrapping Up

We hope this post has helped you to better understand what you need to know about choosing a Medigap policy.

Remember to look at the costs over the whole life of the policy and not just opt for the policy who has the lowest premiums at the start. You’ll also need to think about your pre-existing conditions and choose a plan accordingly. The best thing you can do for your health and your future is to start taking great care of yourself now.

Looking for fitness and health tips? Want to make sure you’re getting the most out of every day? Check out our blog for more advice on staying fit, keeping your finances in good shape, and much more.

Leave a Comment