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Medigap Insurance

ONCE YOU ENROLL in Medicare Part B, you have six months to choose the Medigap policy you want. During this six-month window, you can’t be denied coverage or charged a higher premium because of past or current health issues. If you wait until later, insurers can use medical underwriting, which means policies could cost significantly more, depending on the state of your health, and you may not be able to get the policy you want.

Medigap insurance—sometimes called Medicare supplement insurance—comes in 10 standardized policies, except in Massachusetts, Minnesota and Wisconsin, which have a different set of policies. Depending on the Medigap policy you choose, you will receive help with various deductibles, co-payments and other gaps in Medicare’s coverage.

For instance, a Medigap policy might cover your Part A deductible, the co-insurance for a skilled nursing facility or your Part B deductible. It might also cover you when traveling overseas. Be sure to shop around: Premiums for the same Medigap policy can vary widely. To search for Medigap policies offered in your state, try the Medigap Policy Search tool at Medicare.gov.

It’s possible to change Medigap policies, but tread carefully. Depending on the circumstances, there could be medical underwriting involved, you might pay significantly more and you may not be covered for preexisting conditions for up to six months. Don’t cancel your old policy until you receive written notification that you’ve been accepted for the new policy.

While Medigap policies can plug many of the holes in Medicare, none of them plugs the biggest hole—coverage for custodial care at a nursing home. For that, folks will need to pay out of pocket, buy long-term-care insurance or fall back on Medicaid, and sometimes a combination of all three.

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Previous: Medicare’s Prescription Drug Benefit

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