How Do I Qualify for a Medicare Supplement Plan?

How Do I Qualify for a Medicare Supplement Plan?

Medicare supplement plans, also known as Medigap plans, are designed to fill in gaps left by your typical Medicare Advantage plan. Not everyone can purchase a Medigap policy, however.

To qualify for a Medigap policy, you must:

Be 65 years old or older

Already have Medicare Part A and Part B
Purchase through a private insurer
Pay monthly premiums in addition to your Plan B Medicare premiums
Not have Medicare Advantage

Keep in mind that Medigap coverage is not a replacement for Original Medicare or Medicare Advantage. You cannot purchase Medigap coverage if you have a Medicare Advantage plan unless you are switching back to Original Medicare.

What Does Medigap Cover?

Since Medigap is designed to fill in the holes left by your Original Medicare, it does not cover long-term care or dental procedures. A basic Medigap policy instead covers copayments, coinsurance and deductibles. Some Medigap policies can also cover expenses for medical care you may receive while outside of the U.S. As of 2006, Medigap policies no longer cover expenses related to prescription drug costs. If you have any questions about your Original Medicare, Medigap or Medicare Advantage plan, be sure to speak with your insurance agent. It is critical that you know what you are covered for before an accident ever occurs.

When Can I Buy Medigap Coverage?

You should be able to purchase a Medigap policy during the open enrollment period that begins the month you turn 65. Outside of this enrollment period, it could be difficult or even impossible to get Medigap coverage depending on the insurer and your qualifications. The main exceptions for those who want to purchase Medigap insurance outside of the open enrollment period are people who have a disability or End-Stage Renal Disease (ESRD), have pre-existing conditions or other health problems.

Can I Buy Medigap for Me and My Partner?

Unfortunately, Medigap policies come separately to cover only a single person. If you and your spouse both need Medigap insurance, you will have to purchase two separate policies. Be sure to track both of your open enrollment periods. For some qualifying seniors, enrollment is automatic once they turn 65 years old. Delaying or missing your open enrollment period for Medicare and Medigap can cause you issues in the future when it comes to paying for important medical bills.

If you have any questions about your Medicare or Medicare supplement plans, be sure to speak with your insurer.

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