What is a Medigap Plan?

What Is a Medigap Plan?

If you’re about to sign up for Medicare, you may want to educate yourself on Medigap insurance first. Maybe you’ve already signed up for Medicare, but you’re realizing your Medicare coverage isn’t what you thought it would be. That’s where Medigap comes in. Medigap insurance, or Medicare gap insurance, literally covers the gaps of coverage in your Medicare benefits plan. It pays for healthcare costs that Medicare doesn’t cover, like co-payments and deductibles.

Since it is additional health insurance you buy from a private company, you do have to pay a monthly premium. Also, most Medigap plans don’t cover prescription drugs, but Medicare Part D does. Keep in mind that while Medigap does cover health expenses that Medicare doesn’t, Medigap doesn’t cover healthcare that extends over a long period of time, like private nursing care, staying in a nursing center, hearing aids, dental care, and vision care.

Wondering how to sign up for these Medicare supplement plans? Open enrollment for a Medigap plan is six months from the first day of the month of your 65th birthday. If you’re concerned about out-of-pocket costs that your Medicare plan doesn’t cover, it’s definitely worth it to at least look into some Medigap plans. In fact, in 2010, about 53 percent of all Medigap enrollees had Plan C or Plan F, which cover the Part B deductible. Also in 2010, about 19 percent of 65-year-old beneficiaries, or about 500,000 beneficiaries, purchased a Medigap policy. In other words, hundreds of thousands of people on Medicare want and need a way to pay for out-of-pocket healthcare costs.

What Are the Medigap Policies You Should Know About?

If you’re thinking these Medicare supplement plans are the smart way to go, you should know there are a few rules and regulations. First, you must have Medicare Part A and Medicare Part B to be eligible, and keep in mind that a Medigap plan only covers one person. Take a look at the following bullet points to find out what the other policies are:

  • You pay a monthly premium for the Medigap plan and you also pay the monthly Part B premium to Medicare.
  • You can buy Medigap plans from any insurance company as long as it’s licensed to sell in your state.
  • If you want prescription drug coverage, you will most likely have to join a Medicare Part D plan.
  • If you have a Medicare Medical Savings Account plan, it’s illegal for anyone to sell you a Medigap plan.
  • You can apply for a Medigap plan if you have a Medicare Advantage Plan, but only if your Medicare Advantage Plan ends before your Medigap plan begins.

A Medigap plan can be a great way to go if you’re in the right situation and feel like it will benefit you more than anything else. Understanding these policies beforehand will help you make the most educated and best decision for yourself and anyone living with you.

How is Medigap Different from Medicare Advantage?

In the previous section, something called a Medicare Advantage Plan was mentioned. Wondering that it is? It’s simply another way to cover costs that your original Medicare plan doesn’t cover. So how is it different from a Medigap plan?

Medicare Advantage

  • Medicare Advantage Plans are private health plans (HMOs and PPOs) that Medicare offers as alternative coverage to the traditional program.
  • People on Medicare can receive their Part A and B benefits through one of these private health plans instead of through Medicare.
  • Medicare Advantage plans now cover almost nearly 3 in 10 Medicare recipients.
  • You cannot have a Medigap and Medicare Advantage plan.
  • They are similar to the managed care plans you might have had during your working years.
  • You must see doctors within the plan’s network.
  • Premiums can range from $0 to $200+ a month.

Medigap Plans

  • Cover some of the out-of-pocket costs not covered by Medicare’s Part A and Part B.
  • You will continue to be covered by Medicare.
  • Not a government-run plan, done through private insurance.
  • Technically, only Medigap counts as Medicare supplemental insurance.
  • Premiums can range from $67 to $270 a month, but it all depends on the carrier. The range varies greatly throughout Utah. (https://medigap.utah.gov/medigap/)
  • You can go to any doctors that participate in Medicare.
  • Since Medigap plans are standardized, the benefits are the same no matter which insurance company you choose. In other words, a Plan F from one company has the same medical coverage as Plan F from any other company. The difference is the company itself—the quality of service and the price.

Once again, it’s good to know all your options before making a final choice on how to pay for healthcare expenses that your Medicare plan doesn’t cover. Fortunately, you don’t have to navigate the confusing waters of healthcare alone. EMI Health is an insurance company that is more than happy to help you decide what path to take when it comes to your health.

Contact EMI Health Today for Information on Our Medigap Plans

If you’re interested in learning more about Medigap plans and how they can help you financially, contact EMI Health today. We offer Medigap plans that will help with the expenses you’re not sure how you will pay for. We also offer all types of health insurance, both individual and group health plans that are affordable and high quality. Contact us today by calling 1-800-662-5851 or by visiting www.emihealth.com.


  • https://emihealth.com/emi/products/medicare-products/medigap-plan.aspx
  • http://www.webmd.com/health-insurance/insurance-basics/medigap
  • http://kff.org/medicare/issue-brief/medigap-enrollment-among-new-medicare-beneficiaries/
  • http://www.aarp.org/health/medicare-insurance/info-09-2010/ask_ms_medicare__question_87.html
  • http://www.consumerreports.org/cro/news/2014/10/medigap-vs-medicare-advantage-consumer-reports/index.htm
  • https://www.medicare.gov/supplement-other-insurance/medigap/whats-medigap.html