2021 Guide to choosing a Medigap policy has been published by CMS

The official 2021 Guide to choosing a Medigap Policy has been published by the Centers for Medicare and Medicaid Services (CMS).  This important guide covers topics such as:

• What is a Medicare Supplement Insurance (Medigap) policy
• What Medigap policies cover
• Your rights to buy a Medigap policy
• How to buy a Medigap policy

A Medigap policy is private health insurance that wraps around the Original Medicare Program (Parts A and B) by filling in gaps that otherwise would result in out-of-pocket costs.  This means Medigap will pay some of the costs that Original Medicare doesn't cover, such as copayments, coinsurance and deductibles.  During the six months that follows a Medicare Beneficiary's enrollment in Medicare Part B, Medigap can be purchased on a guaranteed issue basis regardless of health status.  After the six months pass, insurance companies are allowed by law to decline or rate applicants due to health status.

Medigap plans, or Medicare Supplements, are known by their "plan letter name" such as Plan G or Plan N.  Consumers who purchase Medigap typically also buy a Stand-alone Medicare Part D Prescription Drug Plan (PDP), since Medigap policies do not include any drug coverage.

Medigap is entirely different from Medicare Advantage (also known as Medicare Part C), which is a program that delivers both Medicare health and drug benefits through a private insurance company on a year-to-year basis.  Medicare Advantage plans, such as HMOs and PPOs, utilize insurance company networks and often require additional authorization for care access that is not required under Medigap policies.  There is an Annual Election Period (AEP) for Medicare Advantage that runs from October 15th to December 7th; during this period a plan change can be made for the next January 1st.  Medicare Beneficiaries also can disenroll from their Medicare Advantage plan during the AEP, and purchase a Medigap policy (as long as they meet the health eligibility requirements to buy a policy).

Click Here To Download the 2021 Choosing a Medigap Policy Guide

Until next time,

Andrew Herman
AH Insurance Services, Inc.