Original Medicare pays for much, but not all of the cost for covered health care services and supplies. Medicare Supplements, including Medigap and Medicare Advantage insurance help pay for some of the uncovered expenses including co-payments, coinsurance and deductibles. Some Medigap policies also cover medical care when you travel outside the U.S.
Fast Facts About
Medigap insurance is provided by private insurance companies that are approved by Medicare.
- Medigap plans cover some or all expenses for Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage.
- Medigap policies generally do not cover long-term care, vision or dental care, hearing aids, eyeglasses or private-duty nursing.
- A Medigap policy is different from a Medicare Advantage Plan. Medicare Advantage plans are an alternative to Original Medicare while a Medigap policy supplements Original Medicare coverage.
- Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company cannot cancel your Medigap policy so long as you pay the premiums.
- Medigap policies sold after January 1, 2006 do not include prescription drug coverage. If you purchase a Medigap policy and want prescription drug coverage, you you will need to also purchase a Medicare Part D Prescription Drug Plan.
- It’s illegal for anyone to sell you a Medigap policy if you have a Medicare Advantage Plan, unless you’re switching back to Original Medicare.
Medicare Advantage Insurance
Medicare Advantage insurance is also provided by private insurance companies. These policies are generally less expensive than Medigap and frequently provide more benefits. Possibly offsetting these advantages, Medicare Advantage plans frequently have narrow networks that limit participant’s choice of doctors and hospitals.
- Medicare Advantage plans provide Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage.
- There are different types of Medicare Advantage plans including Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service plans, Special Needs Plans, HMO Point of Service plans and Medical Savings Account plans.
- To be eligible for a Medicare Advantage plan, you must have Medicare Parts A and B and live in the plan’s service area.
- Individuals with End-Stage Renal Disease are generally not eligible for Medicare Advantage insurance coverage.
Need Help With Medicare Supplements?
If you find taking advantage of Medicare Supplements confusing, you are not alone. To get help understanding your full range of Medicare benefits, and enrolling in them, just click on the GET HELP button at the bottom of this page. One of our ACCESSMed Volunteers will provide the information and enrollment support that you need. And, there is never a cost for any ACCESSMed service.