Common Medicare Supplement (Medigap) Questions

 Am I eligible to purchase a Medicare Supplement (Medigap) policy?

If you are enrolled in both Medicare Part A and Part B, you can purchase a Medicare supplement insurance policy. If you have had your Medicare Part B six months or less, you are in a period called open enrollment. During your open enrollment period you can apply for a Medicare Supplement policy, also known as a Medigap policy, without having to answer health questions and can’t be denied coverage.

If you are not in your open enrollment period, you will have to answer health questions and be approved for coverage through underwriting. Health questions vary from carrier to carrier, and you can be denied coverage based on certain medical conditions.

There are also situations that fall under guaranteed issue rights. You can’t be denied coverage if you qualify for guarantee issue. Certain life events and insurance changes will allow you to enroll without answering health questions. A licensed agent can assist you in determining if you have guarantee issue rights.

Do I really need Medicare supplemental insurance?

You are not required to purchase a Medicare supplement.  Purchasing a supplement is a personal decision. Original Medicare  has out of pocket expenses such deductibles and copays.  A Medicare Supplement will cover most if not all your financial responsibility verses if you only had Original Medicare. It will cover your copays, deductibles, coinsurance, and hospice care.

What pays first, Original Medicare or the Medicare supplemental insurance?

Your Medicare Part A and B is your primary insurance and will pay first. Your Medicare Supplement will then pay for the “gaps” that would normally be your responsibility.  Your medical providers will file your claims to Medicare.  Original Medicare will pay its portion and then forward the medical claim to your Medicare supplemental policy.

How do I choose a Medicare supplement policy?

You will have options to select from and pricing will be based on which option you select for coverage.  Medicare Supplement plans are identified by letters.  The more common Medicare supplemental plans are Plan F, Plan G, and Plan N.

 Is a Medicare Advantage plan the same as a Medicare Supplement plan?

Medicare Advantage and Original Medicare are two different ways to provide coverage.  You can’t have both.  Medicare Advantage plans are also known as Medicare replacement plans.  If you enroll in a Medicare Advantage (Medicare Part C), it will be your primary insurance and will replace Original Medicare.

You do not need a Medicare supplement plan if you are enrolled in a Medicare Advantage plan.  Medicare supplement plans (Medigap) only work with Original Medicare.

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