Medicare Supplement

Medicare Part A and Part B enrollment is required to be eligible for Medigap coverage.

A Medigap policy is distinct from a Medicare Advantage Plan, as the former supplements Original Medicare benefits.

In addition to the monthly Part B premium paid to Medicare, a monthly premium must be paid to the private insurance company for the Medigap policy.

Each individual requires a separate Medigap policy; coverage cannot be shared between spouses.

Medigap policies can be purchased from any licensed insurance company in the state.

Any standardized Medigap policy is guaranteed renewable, meaning the policy cannot be canceled due to health conditions as long as premiums are paid.

Medigap policies sold after January 1, 2006, do not include prescription drug coverage. To obtain prescription drug coverage, one can join a Medicare Prescription Drug Plan (Part D).

It is prohibited to sell a Medigap policy to someone with a Medicare Advantage Plan unless they are switching back to Original Medicare.

Enrolling in Medigap insurance typically involves a one-time open enrollment period of six months starting from the date of Medicare Part B enrollment. During this period, individuals cannot be denied coverage or charged higher premiums based on health conditions. After this window, insurance companies may consider health status and may refuse coverage, underscoring the importance of enrolling during the open enrollment period.

Eligibility for Medigap insurance requires enrollment in Medicare, specifically Medicare Part A and Part B. Generally, individuals aged 65 and older, those diagnosed with end-stage renal disease (ESRD) requiring dialysis or transplant, and individuals receiving disability benefits for at least 24 months from the Social Security Administration or the Railroad Retirement Board are eligible for Medicare and subsequently Medigap coverage.