Medicare Supplement Insurance, commonly referred to as Medigap, helps pay some of the costs not covered by Original Medicare. Unfortunately, Medigap can be very confusing (not unlike the rest of the Medicare program). This confusion likely explains the many myths surrounding Medicare Supplement Insurance. In this post, we debunk nine of the most common Medigap myths.
Medigap Myth 1: Medicare Advantage Plans Fall Under the Umbrella of Medigap
Fact: You can only have a Medigap plan if you have Original Medicare (Parts A and B). If you have a Medicare Advantage (MA) plan, you do not qualify for Medigap.
The confusion here may relate to the fact that both Medicare Advantage plans and Medicare Supplement Insurance offer additional coverage beyond Original Medicare. The difference is in how they offer that coverage.
Medicare Advantage plans typically offer services beyond those covered by Original Medicare. The most common are prescription drugs and vision care, but you also find plans that include dental, hearing, and more.
Medigap plans help pay some of your out-of-pocket costs. Which costs it covers depends on the plan you choose, although all of them cover your Part A coinsurance. They also pay for an additional 365 days, beyond what’s included in Medicare Part A.
Medigap Myth 2: All Insurance Companies Offer the Same Medigap Plans
Fact: Insurance companies get to choose which supplement plans they offer. However, all Medigap providers must offer at least Plan A as well as either Plan C or Plan F.
Medigap Myth 3: You Can Only Change Medigap Plans During Annual Enrollment
Fact: You can enroll in a supplement plan any time you wish. However, the only time you’re guaranteed coverage is if you sign up during your 6-month Medigap open enrollment period. This window opens as soon as you are enrolled in Part B and are age 65 or older.
If you choose to wait, your Medicare Supplement Insurance application goes through a process known as medical underwriting. The insurer may deny you coverage based on your medical history. Or, they may charge you a higher rate. That’s why we always recommend signing up for Medigap as soon as you become eligible.
Medigap Myth 4: Medigap Only Covers Services Received In-Network
Fact: This is another myth that seems to confuse Medigap with Medicare Advantage. Most MA plans require you to receive services from a network of providers. Medigap pays for services received as long as that service is covered by both Original Medicare and your Medigap plan.
Medigap Myth 5: A More Expensive Medigap Plan Saves You Money Over Time
Fact: Although “you get what you pay for” is often true, that doesn’t necessarily mean that the most expensive Medigap plan offers the best savings. For example, we typically recommend Plan G, which is less expensive than Plan F. That’s because coverage for the two plans is identical except for one thing: Plan G does not cover the Part B deductible. However, the difference in monthly premiums usually means that Part G costs you less per year than Plan F does.
Medigap Myth 6: You Should Only Buy from the Biggest Insurance Company
Fact: Medigap plans are standardized. That means there is no difference in what your plan covers, how much it covers, and when you receive coverage, no matter which insurer you choose. There is, however, a difference in price. Since Medigap plans are offered through private insurers, they get to set their own rates as far as monthly premiums. No matter how much higher the premium is, though, your coverage is the same.
Medigap Myth 7: My Spouse and I Can Get Prescription Drug Coverage with a Medigap Plan
Fact: There are two things wrong with this myth. First, a supplement plan only covers one person; you cannot share it with your spouse. Second, Medigap plans do not cover prescriptions. To get this coverage under Original Medicare, you must enroll in a Part D plan.
Medigap Myth 8: You Can Pay for Long-Term Care with Your Medigap Plan
Fact: Medigap plans do not cover long-term care expenses. They only pay for services covered under Original Medicare. Some Medigap plans cover your coinsurance for skilled nursing facility care. In addition, all of them pay at least part of your out-of-pocket costs for hospice care (covered under Part A).
Medigap Myth 9: Purchasing a Medigap Policy Through an Agent Is More Expensive
Fact: Using one of the licensed agents at Medicare Solutions adds nothing to the cost of your monthly premium. What’s more, it could save you money. That’s because licensed agents understand these programs in a way most people don’t. We can help you understand your options to ensure you don’t buy more coverage than you need. Working with an expert is also a better use of your valuable time.
Are you ready to start comparing your Medigap plan options? Give us a call toll-free at 855-350-8101. One of our licensed agents is happy to assist you.