Medigap Supplemental Insurance Explained

Medigap, also known as Medicare Supplemental Insurance, is a health insurance policy sold by private insurance companies that fills the gaps that Medicare fails to cover, such as coinsurance, co-payments and deductibles. There are ten distinct Medigap policies, Medigap Plans A-J. There are also two other Medigap policies, K and L, which only pay a portion. All policies are regulated by the federal and state governments. Residents of Massachusetts, Minnesota and Wisconsin have specialized plans. Plans K and L only provide benefits that supplement those covered under Medicare Parts A and B; both plans require a specific amount of out-of-pocket expenditure before paying the full supplemental benefit for the remainder of the calendar year. For a full description of all Medigap policies, visit Medicare.gov.

Medigap Policies

Medigap covers the following, depending on the policy:

  • Stays in a skilled nursing facility
  • Blood (first 3 pints annually)
  • Medicare Part A coinsurance and hospital benefits
  • Medicare Part B annual deductible
  • Medicare Part B co-payments
  • Excess doctor charges
  • Foreign travel emergencies
  • Routine checkups
  • At-home recovery

Medigap coverage is renewed annually and requires a monthly premium. There are several important considerations when shopping for Medigap. First, a number of insurance companies offer policies with identical benefits, but at different rates. Second, not every company offers all policies. Make sure you carefully consider which policy is the best for your needs. If you are married, you and your spouse must purchase separate policies.

Eligibility and Qualifications

  • Must be a recipient of both Medicare Part A and Medicare Part B
  • Cannot be a Medicaid recipient