Top Medicare Supplement Questions and Answers

As a licensed independent Medicare Supplement (Medigap) agent since 2010, I’ve been asked many questions about Medicare and “supplemental” plan options. To help, here are the answers to the most common Medicare Supplement questions.

Who is eligible for Medicare Supplement (Medigap) insurance?

If you’re over 65 and enrolled in Medicare Part A (80% Hospital) and Part B (80% Medical), you can apply for Medicare Supplement (Medigap) insurance. An open enrollment period occurs within six months of obtaining Medicare Part B, and you can apply for a Medicare Supplement (Medigap) policy without answering health questions. This is called the Medigap Open Enrollment Period.

If you are not in your Medigap Open Enrollment Period or eligible for Guarantee Issue, you must answer health questions to qualify. Those individuals within their Medigap Open Enrollment Period or eligible for guaranteed issue would not need to answer the health questions to qualify.

I can help you determine which enrollment period you qualify for and help with any other Medicare Supplement questions you have.

Is Medicare Supplement (Medigap) insurance required?

No, you don’t have to have supplemental insurance with Medicare. Medicare Supplement (Medigap) insurance is an add-on, just like Medicare Part D, which covers prescriptions.

However, you may want to add supplemental coverage to your Original Medicare (Part A and Part B) or a Medicare Advantage plan (Part C) to limit your out-of-pocket exposure to medical costs.

As an independent insurance agent licensed in many states, I work with many reputable insurance companies offering Medicare Supplement (Medigap) and Medicare Advantage (Part C) plans in your area! My services are free to you, as I get compensated by the insurance company. 🙂

Do I need Medicare Supplement (Medigap) insurance?

Just like many healthcare coverage decisions, this is a personal one. Original Medicare (Part A and Part B) has deductibles and coinsurance. If you don’t want to be responsible for those costs, you can add a Medicare Supplement (Medigap) plan. We can shop the market for you in your area for free!

What does Medicare Supplement (Medigap) insurance cover?

Plans pay many of the costs Medicare doesn’t cover, like the Part A deductible ($1632 per occurrence in 2024) plus the 20% coinsurance under Parts A and B, so you have 100% coverage! However, Medicare Supplement (Medigap) plans do not usually cover routine dental, vision, hearing, long-term care, and private-duty nursing care.

If Medicare approves your services or procedures as medically necessary, your Medigap plan will pay accordingly, regardless of the insurance company you purchase your plan through.

Who pays first, Medicare or Medicare Supplement (Medigap) insurance?

Medicare Parts A and B pay first; then Medicare Supplement (Medigap) insurance kicks in to help cover the gaps, like the Part A deductible and Part A and B 20% coinsurance. For Part B services, you must meet the Part B calendar-year deductible first ($240 in 2024) before Medicare or your Medigap plan will pay.

Most healthcare providers have agreed with Medicare to accept all Medicare-covered services and bill accordingly. When providers accept “Medicare Assignment,” they accept Medicare’s reimbursement rates and amounts as payment in full.

How do I choose which Medicare Supplement (Medigap) insurance to get?

Medigap plans are identified by letters, just like the “Parts” of Medicare, which can be confusing. Medigap plans come in A, B, C, D, F, G, K, L, M, and N, with varying costs and coverage, depending on the deductible level and specific plan. Premiums vary by state and plan.

First, let’s decide which benefits you want; then, we can discuss which plan meets your needs and is available in your state. Then I can provide you with a quote.

What is the difference between Medicare Advantage and Medicare Supplement plans?

Medicare Supplements are supplemental plans with a monthly premium designed to cover the remaining costs like deductibles and copays generated from Original Medicare Part A and Part B. Your out-of-pocket for hospital and doctor services is much less, and you can use any Hospital or Doctor that accepts Medicare.

Medicare replacement insurance is another term for Medicare Advantage (Part C), the primary payor for medical services received while insured under a Medicare Advantage plan. It replaces Original Medicare as the primary payor. Plans include Hospital, Doctor, and Drug coverage, in addition to some Dental and Vision services not covered by Medicare.

With Medicare Advantage plans, you may not have a monthly premium ($0/mo), but your out-of-pocket potential is much greater than that of a Medicare Supplement plan. Plans also use networks, so it’s important to ensure your providers accept the plan you’re interested in. I can help with this!

You cannot have Medicare Supplement insurance with Medicare Advantage plans, but other types of supplemental insurance, like Hospital Indemnity and First Diagnosis Cancer, pair well with Medicare Advantage plans.

Do you have Medicare Supplement questions or need help navigating your options?

For more information on plans and rates and to get your Medicare Supplement questions answered, please call me at (888) 901-4870. I can help you with Medicare Advantage and Medicare Part D Rx plans too!

You can also schedule a call with me here >> Schedule Phone Appointment with Chad