Medigap Plans – Three Things Most People Do Not Know

Medigap plans can be intimidating to many people – understanding and thinking about insurance is not at the top of most people’s to-do list. The plans, however, are really not as complex and confusing as many people make them. Also, they are not nearly as complex as many other types of insurance. Due to the standardization of plans, the fact that the coverage is supplemental and pretty straight-forward, and the lack of network considerations, the plans can be very easy to understand.

There are, however, a few misconceptions and myths that people seem to have about Medigap plans on an ongoing basis. The top three, that I have seen in my experience of talking to hundreds of Medicare beneficiaries a week, are:

  1. Medigap plans are different from Medicare Advantage plans. And, Medicare Advantage plans do not supplement Medicare.
    Medigap plans are designed to work with and “supplement” Medicare. They fill in the gaps in the Medicare program – Parts A & B. Medicare Advantage, on the other hand, are plans that replace the Federal Medicare program, providing all of the benefits through a privatized system of co-pays and deductibles. There are many differences between Medigap and Medicare Advantage plans, including coverage, doctor accessibility, plan portability, freedom to change plans later, etc. Although many people lump all plans in together, these two types of plans are very different.
  2. Medigap insurance does not have an annual enrollment period.
    Another difference not mentioned above is that Medigap plans do not have an annual enrollment period, contrary to popular belief. The end of year enrollment period is actually for Medicare Advantage and Medicare Part D (Rx coverage) plans. It does not apply at all to Medigap plans, which do not have an enrollment period. You can compare, change, enroll in, or disenroll from a Medigap plan at any time of the year.
  3. Medigap is the same, virtually, nationwide and the plans are portable. Likewise, there are no networks of doctors/hospitals that you must stay within.
    Medigap plan benefits are nationally standardized, and with the exception of a couple of states that vary from this (i.e. Wisconsin), the plans are the same in all 50 states. Also, if you move to a new state, you do not need to change Medigap plans – the plans can be used anywhere nationwide that takes Medicare. There are no regional-based networks or doctor use restrictions (i.e. referrals required, etc).

Overall, there are many misunderstandings about all types of insurance, including Medigap insurance. But Medigap plans are relatively simple and can be understood with some simple research and reading. If you have questions about Medigap plans or anything else as it relates to Medicare, please call us at 877.506.3378. Or, you can contact us online at Medicare-Supplement.US.

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