- Medigap helps to pay for some of the healthcare costs that aren’t covered by original Medicare.
- The costs you’ll pay for Medigap depend on the plan you choose, your location, and a few other factors.
- Medigap usually has a monthly premium, and you may also have to pay copays, coinsurance, and deductibles.
Medicare is a health insurance program offered by the federal government for people age 65 and over, as well as other specific groups. It’s estimated that original Medicare (parts A and B) covers about
Medicare supplement insurance (Medigap) helps pay for some of the healthcare costs that aren’t covered by original Medicare. About
The cost of a Medigap plan can vary due to several factors, including the type of plan you enroll in, where you live, and the company selling the plan.
Below, we’ll explore more about the costs of Medigap plans in 2021.
Medigap is supplemental insurance that you can buy to help pay for things that aren’t covered by Medicare Part A and Medicare Part B. Some examples of the costs that may be covered by Medigap include:
- deductibles for parts A and B
- coinsurance or copays for parts A and B
- excess costs for Part B
- healthcare costs during foreign travel
- blood (first 3 pints)
The specific things that are covered depend on the Medigap plan that you purchase. There are 10 different types of Medigap plans, which are each designated with a letter: A, B, C, D, F, G, K, L, M, and N. Each plan has a different level of coverage.
Private insurance companies sell Medigap policies. Each plan is standardized, meaning that it has to provide the same basic level of coverage. For example, a Plan G policy covers the same basic set of benefits, regardless of its cost or the company that’s selling it.
Medigap policies are also guaranteed renewable as long as you pay your monthly premiums. This means that the insurance company you purchased your plan from cannot cancel your plan, even if you have new or worsening health conditions.
So what are the actual costs associated with Medigap plans? Let’s examine the potential costs in more detail.
Each Medigap policy has a monthly premium. The exact amount can vary by individual policy. Insurance companies can set monthly premiums for their policies in three different ways:
- Community rated. Everyone that buys the policy pays the same monthly premium regardless of age.
- Issue-age rated. Monthly premiums are tied to the age at which you first purchase a policy, with younger buyers having lower premiums. Premiums don’t increase as you get older.
- Attained-age rated. Monthly premiums are tied to your current age. That means your premium will go up as you get older.
If you’d like to enroll in a Medigap plan, it’s important to compare multiple policies that are offered in your area. This can help you determine how premiums are set and how much you can expect to pay per month.
The Medigap monthly premium is paid in addition to other monthly premiums associated with Medicare. These can include premiums for:
- Medicare Part A (hospital insurance), if applicable
- Medicare Part B (medical insurance)
- Medicare Part D (prescription drug coverage)
Medigap itself isn’t typically associated with a deductible. However, if your Medigap plan doesn’t cover the Part A or Part B deductible, you’re still responsible for paying those.
Medigap Plan F and Plan G do have a high-deductible option. The monthly premiums for these plans are typically lower, but you’ll have to meet a deductible before they start to cover costs. For 2021, the deductible is $2,370 for these plans.
Coinsurance and copays
Like deductibles, Medigap itself isn’t associated with coinsurance or copays. You may still have to pay certain coinsurance or copays associated with original Medicare if your Medigap policy doesn’t cover them.
In 2021, the Plan K and Plan L out-of-pocket limits are $6,220 and $3,110, respectively. After you meet the limit, the plan pays for 100 percent of covered services for the rest of the year.
There are some health-related services that aren’t covered by Medigap. If you need to use these services, you’ll have to pay for them out of pocket. These may include:
The following table shows a cost comparison of monthly premiums for the different Medigap plans in four sample cities across the United States.
|Washington, D.C.||Des Moines, IA||Aurora, CO||San Francisco, CA|
|Plan F (high deductible)||$27–$86||$27–$76||$32–$96||$28–$84|
|Plan G (high deductible)||$26–$53||$32–$72||$37–$71||$38–$61|
The prices shown above are based on a 65-year-old man who doesn’t use tobacco. To find prices specific to your situation, enter your ZIP code in Medicare’s Medigap plan finder tool.
There are certain rules associated with buying a Medigap policy. These include:
- You must have original Medicare (parts A and B). You cannot have Medigap and Medicare Advantage.
- A Medigap plan only covers a single person. This means spouses will need to purchase separate policies.
- By federal law, insurance companies aren’t required to sell Medigap policies to people under age 65. If you’re under 65 and have original Medicare, you may not be able to purchase the policy that you want.
Additionally, some Medigap plans are no longer available to those who are new to Medicare. However, people who are already enrolled in these plans can keep them. These plans include:
Below are some important dates for enrolling in a Medigap plan.
Medigap initial enrollment period
This period starts is the 6-month period that starts when you turn age 65 and have enrolled in Medicare Part B. If you enroll after this time, insurance companies may increase the monthly premiums due to medical underwriting.
Medical underwriting is a process that’s used by insurance companies to make decisions about coverage based on your medical history. Medical underwriting is not allowed during Medigap initial enrollment.
Other Medicare enrollment periods
You can still purchase a Medigap plan outside of your initial enrollment period. Here are the other time periods when you may enroll in a Medigap plan throughout the year:
- General enrollment (January 1–March 31). You may switch from one Medicare Advantage plan to another, or you can leave a Medicare Advantage plan, return to original Medicare, and apply for a Medigap plan.
- Open enrollment October 15–December 7). You may enroll in any Medicare plan, including a Medigap plan, during this period.
Medigap is a type of supplemental insurance that you can purchase to help pay for health-related costs that aren’t covered by original Medicare. There are 10 different types of standardized Medigap plan.
The cost of a Medigap plan depends on the plan you choose, where you live, and the company from which you purchase your policy. You’ll pay a monthly premium for your plan and may also be responsible for some deductibles, coinsurance, and copays.
You can first enroll in a Medigap plan during Medigap initial enrollment. This is when you turn age 65 andenroll in Medicare Part B. If you don’t enroll during this time, you may not be able to enroll in the plan that you want or it may cost more.
This article was updated on November 20, 2020, to reflect 2021 Medicare information.
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