Medigap (Medicare Supplement Insurance)
Plain English
Medigap is extra private insurance that helps pay what Original Medicare doesn't, like copays, coinsurance and deductibles. You generally need Medicare Parts A and B to buy it. Timing matters most: during your one-time 6-month Medigap open enrollment, insurers can't turn you down or charge more for health problems. After that, they may.
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Definition
Medicare Supplement Insurance (Medigap) is private insurance sold to people with Original Medicare, Part A and Part B, to help pay their share of out-of-pocket costs such as copayments, coinsurance and deductibles. Under federal law, a person gets a one-time, 6-month Medigap Open Enrollment Period starting the first month they have Part B and are 65 or older, during which insurers can't use medical underwriting to deny coverage.
Why It Matters
Medigap's open enrollment period is one of the easiest Medicare deadlines to miss, and it doesn't come back each year. Someone who skips Medigap at 65 and develops a health condition later may find that insurers can deny them or charge more, unless a guaranteed issue right or state law applies.
Real-World Example
Imagine someone starts Part B in March at 66, having worked past 65 with employer coverage. Their Medigap Open Enrollment Period runs from March through August. They buy a Medigap policy in May; the insurer can't refuse them or charge more for their diabetes. Had they waited until the following year, the insurer could have used medical underwriting.
Common Misconceptions
- Medigap works with Medicare Advantage. Medigap supplements Original Medicare; it's generally not sold to people in a Medicare Advantage plan.
- You can buy Medigap any time with the same protections. The 6-month open enrollment is one-time; afterward, you may be denied or charged more.
- Medigap covers prescription drugs. Medigap policies sold today generally don't; drug coverage comes from Part D.
Key Takeaways
- Medicare.gov: "Under federal law, you get a 6 month Medigap Open Enrollment Period."
- It starts the first month you have Part B and you're 65 or older.
- During it, an insurer can't refuse to sell you any Medigap policy it offers or charge more for pre-existing health problems.
- It's one-time, not yearly. Ask your State Insurance Department about any extra rights under state law.
Frequently Asked Questions
What is Medigap?
Private Medicare Supplement Insurance that helps pay your share of costs in Original Medicare, like copays, coinsurance and deductibles.
When can I buy a Medigap policy?
Best during your 6-month Medigap Open Enrollment Period, which starts the first month you have Part B and are 65 or older. Afterward, you may pay more or be denied, unless a guaranteed issue right applies.
Can I be denied Medigap coverage?
Not during your Medigap Open Enrollment Period. Outside it, Medicare.gov says an insurer can deny you if you don't meet its medical underwriting requirements.
Can I have Medigap and Medicare Advantage?
Generally not. Medigap works with Original Medicare, not Medicare Advantage plans.
Does Medigap cover prescriptions?
Policies sold today generally don't. Drug coverage comes from a Medicare Part D plan.
State-specific note: Some states give extra rights to buy or switch Medigap policies, and some require insurers to sell Medigap to people under 65 with Medicare due to a disability. Check with your State Insurance Department.
Related Terms
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- Medicare
- Health Insurance
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Explore the rest of the Medicare category.
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The factual claims on this page were checked against these sources. Rules and figures change, so check the source itself if you need to confirm the current version.
- medicare.govWhat's Medicare Supplement Insurance (Medigap)? · Medicare.gov (U.S. Centers for Medicare & Medicaid Services)
- medicare.govGet ready to buy (Medigap) · Medicare.gov (U.S. Centers for Medicare & Medicaid Services)
Educational information, not advice: This page is for general education only, not legal, financial, or insurance advice. Actual coverage, discounts, and requirements depend on your policy’s wording, your insurer, and the laws of your state. Confirm specifics with your own insurer or a licensed agent before making a decision. Insurpedia does not sell insurance and does not recommend specific insurers.