Who's Eligible for a Medigap Insurance Policy?
What is medigap insurance and who's eligible?
A medigap insurance policy covers many medical costs that Medicare insurance may not pay for. If you're near or already age 65, you probably know that Medicare ends up paying for only about half of all medical costs. Part of this slack is taken up by Medicare Part D prescription drug plans, which pay some of the high cost of medicines. And some people fill coverage gaps by leaving traditional Medicare and joining a Medicare Part C Medicare Advantage managed care plan.
You or someone you're caring for may be part of the majority, though, that stays in traditional Medicare Part A and Part B. If so, you may want to investigate buying a medigap supplemental insurance policy, with 10 types of plans to choose from.
More about medigap insurance
Not everyone is allowed to buy any medigap policy at any time. Whether you can buy a particular policy, and under what terms, depends on when you apply and what other coverage you've had. Understanding these restrictions can help you take full advantage of the medigap policies available to you.
Medigap insurance policies fill part of the gaps in medical costs that Medicare Part A and Medicare Part B don't pay. The types of medigap policies that can be sold are regulated by the federal government, but the policies themselves are sold by private insurance companies. If you're enrolled in Medicare Part A and Part B, you'll find that both Part A and Part B have deductibles, copayments, and uncovered expenses that you're personally responsible for. A medigap policy pays some or all of these costs.
If you're enrolled in a Medicare Part C "Medicare Advantage" managed care plan and want to keep that plan, you do not need a medigap insurance policy.
What medigap insurance policies is someone eligible for at age 65?
Most people enroll in Medicare at age 65. Within six months of first signing up for Medicare Part B, you have "guaranteed enrollment" in a medigap policy. This means that you can buy any medigap policy offered in the state where you live, in any of 10 plan categories.
An insurance company must sell you the policy of your choice without any medical screening, regardless of your medical history. The company isn't permitted to place any extra limits on the coverage offered. And you must be offered the policy for the same monthly premium as everyone else buying the same policy when first eligible for Medicare.