Medigap, also called Medicare Supplement Insurance, is a plan sold by private companies. It does exactly what the name implies; it helps fill the “gaps “in Original Medicare. Medigap policies also can cover services that Original Medicare does not. Even though Medicare helps pay for the majority of covered healthcare services and supplies, you may still need additional help.

Medigap can help cover the remaining costs associated with:

• Copayments
• Coinsurance
• Deductibles
• Some will cover the costs associated with medical care when traveling outside of the U.S.

Things to know about Medigap:

1. Medicare Part A and Part B are required.
2. Unlike Medicare Advantage Plans, that are a way to get Medicare benefits, Medigap only supplements your Original Medicare.
3. In addition to paying your Medigap monthly premium, you will also be responsible for your Medicare Part B monthly premium from Original Medicare.
4. Medigap only covers one individual. If your spouse would like to be covered via Medigap, then an additional policy would need to be purchased.
5. Medigap policies can be purchased from any insurance company licensed in your state.
6. Guaranteed renewal regardless of health problems as long as your premium is paid on time.
7. Medigap does not include prescription drug coverage. Medicare Part D must be added.
8. It is against the law for anyone to sell you a Medigap policy while you have a Medicare Advantage Plan. This can only be done if you are switching back to Original Medicare.

You are solely responsible for your Medigap coverage premium; Medicare does not pay for this.

How Medigap helps pay your Part B claims:

Normally your Medigap insurance company will work with Medicare to get your Part B claim information. From there, payment is submitted directly to your doctor. In some cases, the same is done with Part A claims.

In the event that your Medigap insurance company does not provide this service, you may need to speak with your doctor and verify if they accept or “participate” in Medicare. If they do participate or “accept assignment”, then your Medigap insurance company is required to submit, payment directly to your doctor per your request.