health
Who qualifies for Medicare supplemental insurance?
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TL;DR
- Medigap policies supplement Original Medicare (Parts A and B) by covering costs like deductibles and coinsurance.
- To purchase Medigap, you generally need to be enrolled in both Medicare Part A and Part B, and cannot have a Medicare Advantage plan.
- The Medigap Open Enrollment Period, a six-month window starting when you are 65 and enrolled in Part B, provides guaranteed issue rights and protection against health-based underwriting.
- Outside of this enrollment period, obtaining Medigap may involve medical underwriting, potentially leading to higher premiums or denial of coverage, unless state laws or guaranteed-issue rights apply.
- Eligibility rules for those under 65 with Medicare due to disability or ESRD can be more complex, with federal law not always requiring insurers to sell Medigap policies, though some states offer protections.
- Medigap does not cover routine dental, vision, hearing aids, or prescription drugs (which require a separate Part D plan).
- Considering Medigap may be beneficial if you anticipate frequent healthcare use, have limited budget for unexpected bills, or desire protection against large out-of-pocket expenses, including potential foreign travel emergency care.