Medicare Supplement Insurance, or Medigap, is additional insurance that one can purchase from a private health insurance company. Buying the extra plan could help an individual pay their share of out-of-pocket costs in Original Medicare. The insured usually has to have original Medicare Part A (hospital insurance) and Part B (medical insurance) to purchase a Medigap policy. Here are some of the important things there are to know about Medigap plans:

1. Costs
Medigap is an optional insurance policy that may require individuals to pay a monthly premium to the private insurance carrier. The cost is in addition to the monthly Part B premium paid to Medicare. Some Medicare supplement insurance plans might have deductibles. A copayment might also apply to specific services under the Medigap plan. One should also note that the cost of coinsurance may vary based on the plan. The cost of the policy depends on the plan type and health insurer. It may also include other factors such as age, sex, location, and health information. For instance, the premiums for a 65-year-old with the least-expensive plan might be as low as $30 to $40 monthly. However, the premium might cost hundreds of dollars per month for older beneficiaries and plans with greater coverage.

2. Limitations
There are a few things to consider where limitations are concerned. Medigap coverage usually has no network limitations and is available at all locations where Medicare is accepted. Some of the plans even cover foreign travel emergency services. Furthermore, once an individual has enrolled in a plan, it renews annually as long as the premium is paid and the policy is available. Things that might not be covered under Medigap include long-term care, such as at nursing homes, vision or dental care, hearing aids, eyeglasses, and private-duty nursing. One should remember that they might be able to enroll in a separate Medicare plan for prescriptions (Part D) if they want such coverage.

3. Initial enrollment period
Like most insurance options, Medigap plans have an initial enrollment period—a limited time when one can enroll in Original Medicare (Part A and Part B) when first eligible. Once the individual is enrolled in the respective Medicare plans, they can pick other coverage options from approved private insurers, such as a Medigap plan. The best period to purchase a Medicare Supplement is the six-month period that begins on the first day of the month the individual turns 65 or older, considering they are enrolled in Part B. Following the dedicated time frame, the person’s ability to purchase a Medigap policy might be limited and more expensive.

4. When to enroll
An individual is first eligible for a Medigap plan during the Initial Enrollment Period for Medicare Part A and Part B, which lasts seven months and starts when they qualify for Medicare. This is based on two primary factors. The first is the individual’s age, which begins three months before they turn 65 and extends until three months after the birth month. The second instance is for individuals aged under 65 with an eligible disability. Here, the initial enrollment period is based on when the person began receiving Social Security or Railroad Retirement Board (RRB) disability benefits. This period begins the 22nd month after the person starts to receive benefits and continues until the 28th month after they begin receiving benefits.

5. Open enrollment period
Those interested in Medigap may also be eligible for the open enrollment period. The open enrollment time frame for Medicare Supplement Insurance is the six-month period that starts on the first day of the month the individual turns 65 or older and is enrolled in Part B. Following the period, the person’s ability to buy a Medigap policy might be limited and expensive. One should note that each state might have different rules, and there might be additional open enrollment periods in some situations.

6. Medigap vs. Medicare Advantage
People often think a Medigap policy is the same as a Medicare Advantage (Part C) plan. However, this is not true. A Medicare Advantage plan is an alternative way to obtain Medicare benefits once the individual qualifies. On the other hand, a Medigap plan helps bridge any gaps in the original Medicare coverage and is purely a supplemental type of plan. Moreover, while a Medigap plan might have higher premiums, it may pay off in fewer out-of-pocket costs. However, one should do ample research before purchasing the policy to ensure they get the best value for their money.