Medicare is a helpful insurance tool that helps cover your medical and hospital expenses. However, it has certain limitations and you still end up paying a large part of your medical expenses not covered by Medicare. Fortunately, there is Medigap Insurance (also called, Medicare Supplements) that provides coverage for areas where Medicare cannot cover. Perhaps you’ve been asking, ‘What is Medigap Insurance?’ As the name suggests, Medigap fills the gap of and gives you a lot of other benefits not found in your Medicare insurance.

What is Medigap Insurance – a Closer Look

As to the question, ‘What is Medigap Insurance?’, Medigap Insurance is different from a Medicare Advantage Plan. Where the Medicare Advantage Plan gives you access to Medicare benefits, Medigap fills the shortcomings of your Medicare policy. It helps pay your share of your Medicare costs. These shares include coinsurance, copayments, and deductibles. Coinsurance is a percentage you pay, copayment is a set amount, like $25) while deductibles are what you pay before your plans kicks in.

Medigap Insurance can be purchased during your Medigap open enrollment period which starts when you turn 65 or more and a holder of Medicare Plan B. This period lasts for 6 months and does not require medical underwriting.You can purchase it from authorized insurance companies. During this time, you can apply for a policy without worrying about being disapproved or paying more premiums even if you have pre-existing medical conditions.

What is Medigap Insurance – Rating Premiums

Medigap Insurance has 12 standard policies which are set by the government. The price of each policy, however, is determined by insurance companies and rated in three ways – community rated, issue-age rated, and attained-age rated. Each of these pricing types has their own advantages and disadvantages.

  • Community rated – The premium isn’t based on your age but can go up because of inflation. Therefore, it doesn’t matter when you buy the policy because you will still be charged the same.
  • Issue-age rated – The premium is based on age; thus, the older you are when you enroll, the higher the premium. The good news, though, is your premiums don’t increase even as you grow older.
  • Attained-age rated – The premium is based on your age as well. The only difference is that the premiums go higher every year. However, these plans usually more affordable than the above if you are under 75.

What is Medigap Insurance – Important Facts

If you haven’t acquired or have been planning to get a Medigap insurance policy, there are a few things you need to know in order to avoid problems in the future when making a claim. This information will help you understand what to expect and not to expect regarding your Medigap policy.

  • A Medigap Insurance policy requires you to have Medicare A and B
  • You and your spouse need separate policies because it only covers one person
  • You don’t need Medigap Insurance if you have a Medicare Medical Savings Account or MSA Plan
  • You cannot have a Medigap Insurance policy and a Medicare Advantage Plan together
  • Your Medigap Insurance premium is different from your Medicare premium
  • Your Medigap Insurance policy is renewable and can’t be cancelled by the insurance company as long as you’re paying the premiums
  • Your Medigap Insurance doesn’t cover prescription drugs, long-term care, private-duty nursing, hearing aids, and dental and eye care
  • You, not your agent, can cancel your Medigap policy by calling your insurance provider
  • You can purchase your Medigap policy from an insurance broker, like Medicare Pathways, Inc.


What is Medigap Insurance – Non-Medigap Insurance Policies

Aside from the difference between Medicare and Medigap, there is still some confusion regarding Medigap and other types of insurance. The plans listed below are NOT Medigap plans.

  • Medicaid
  • Medicare Prescription Drug Plans
  • Medicare Advantage Plans, such as HMO and PPO
  • Employer and union plans
  • Federal Employees Health Benefits Program
  • Veteran’s Benefits
  • Indian health Service and similar policies
  • Long-term Insurance policies


Medigap Insurance boosts your Medicare cover by supplementing it. You can choose any type of Medigap policy which fits your needs. A Benefit Advisor ar Medicare Pathways can answer your questions on Medigap and provide free quotes.  Click here to request a quote!


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