Question: Do I need Medigap coverage?
Answer: Medigap coverage provides supplemental health insurance for Medicare recipients. While Medicare Parts A and B cover many hospitalization and outpatient services, you are still required to make co-payments and pay for some treatments out-of-pocket. A Medigap plan generally offers low-cost health insurance to cover the "gaps" in Medicare coverage.
For most of the country, Medigap plans are standardized and labeled Plans A-N. This means that the federal government requires all Medigap supplemental health insurance policies under the same plan letter to provide the same coverage. Therefore, Plan A offered by one insurance company is the same as Plan A offered by another insurance company. The only difference may be the premium amount, which is why it is important to compare rates and shop around for coverage.
However, the states of Massachusetts, Minnesota, and Wisconsin have their own standardized plans. Residents of these states should check with their state insurance office for more information regarding their Medigap medical insurance options.
Supplemental health insurance through Medigap pays many of your Medicare co-insurance and deductibles. In addition, you may want to purchase a Medigap supplemental health insurance policy if you:
- Expect to be hospitalized more than 60 days a year
- Want coverage for preventative care such as annual check-ups
- Need frequent blood transfusions
- Travel out of the country
- Want to use a skilled nursing facility or hospice
While Medigap plans can be a smart choice for low-cost health insurance, these policies are not for everyone. If you have a Medicare Part C plan, otherwise known as Medicare Advantage, you should not apply for a Medigap policy. Supplemental health insurance is not necessary for Medicare Advantage participants, and your Medigap plan may not provide you with any additional medical coverage.