Medigap (Medicare Supplement Health Insurance)
Medigap (Medicare Supplement Health Insurance)
A Medigap policy is health insurance sold by private insurance companies to fill the “gaps” in Original Medicare Plan coverage. Medigap policies help pay some of the health care costs that the Original Medicare Plan doesn't cover. If you are in the Original Medicare Plan and have a Medigap policy, then Medicare and your Medigap policy will each pay its share of covered health care costs.
Generally, when you buy a Medigap policy you must have Medicare Part A and Part B. You will have to pay the monthly Medicare Part B premium. In addition, you will have to pay a premium to the Medigap insurance company. As long as you pay your premium, your Medigap policy is guaranteed renewable. This means it is automatically renewed each year. Your coverage will continue year after year as long as you pay your premium. In some states, insurance companies may refuse to renew a Medigap policy bought before 1992.
Insurance companies can only sell you a “standardized” Medigap policy. Medigap policies must follow Federal and state laws. These laws protect you. The front of a Medigap policy must clearly identify it as “Medicare Supplement Insurance.”
It's important to compare Medigap policies, because costs can vary. The standardized Medigap policies that insurance companies offer must provide the same benefits. Generally, the only difference between Medigap policies sold by different insurance companies is the cost.
You and your spouse must buy separate Medigap policies. Your Medigap policy won't cover any health care costs for your spouse.
Some Medigap policies also cover other extra benefits that aren't covered by Medicare.
You are guaranteed the right to buy a Medigap policy under certain circumstances.
For more information on Medigap policies, you may call 1-800-633-4227 and ask for a free copy of the publication “Choosing a Medigap Policy: A Guide to Health Insurance for People With Medicare.” You may also call your State Health Insurance Assistance Program (SHIP) and your State Insurance Department. Phone numbers for these Departments and Programs in each State can be found in that publication.
NEW! CMS Center for Medicare: NAIC Q&A and Follow-Ups
The FAQ below summarizes CMS’ responses from discussions with NAIC in November 2024 pertaining to a significant change in a Medicare Advantage provider network, relevant special election periods and associated Medigap guaranteed issuance rights for affected beneficiaries.
Generally, when you buy a Medigap policy you must have Medicare Part A and Part B. You will have to pay the monthly Medicare Part B premium. In addition, you will have to pay a premium to the Medigap insurance company. As long as you pay your premium, your Medigap policy is guaranteed renewable. This means it is automatically renewed each year. Your coverage will continue year after year as long as you pay your premium. In some states, insurance companies may refuse to renew a Medigap policy bought before 1992.
Insurance companies can only sell you a “standardized” Medigap policy. Medigap policies must follow Federal and state laws. These laws protect you. The front of a Medigap policy must clearly identify it as “Medicare Supplement Insurance.”
It's important to compare Medigap policies, because costs can vary. The standardized Medigap policies that insurance companies offer must provide the same benefits. Generally, the only difference between Medigap policies sold by different insurance companies is the cost.
You and your spouse must buy separate Medigap policies. Your Medigap policy won't cover any health care costs for your spouse.
Some Medigap policies also cover other extra benefits that aren't covered by Medicare.
You are guaranteed the right to buy a Medigap policy under certain circumstances.
For more information on Medigap policies, you may call 1-800-633-4227 and ask for a free copy of the publication “Choosing a Medigap Policy: A Guide to Health Insurance for People With Medicare.” You may also call your State Health Insurance Assistance Program (SHIP) and your State Insurance Department. Phone numbers for these Departments and Programs in each State can be found in that publication.
NEW! CMS Center for Medicare: NAIC Q&A and Follow-Ups
The FAQ below summarizes CMS’ responses from discussions with NAIC in November 2024 pertaining to a significant change in a Medicare Advantage provider network, relevant special election periods and associated Medigap guaranteed issuance rights for affected beneficiaries.
Downloads
-
NAIC FAQ 11-22-2024 (PDF) -
Sale of Individual Market Policies to Certain Medicare Beneficiaries (PDF) -
High Risk Pool FAQs (PDF) -
12/14/98 Federal Register Notice - Civil Money Penalties, Assessments, Exclusions, and Related Appeals Procedures (PDF, 83 KB) (PDF) -
2008 NAIC Medigap Model Regulation (PDF, 1074 KB) (PDF)
Page Last Modified:
11/25/2024 01:12 PM