Why You Should Get a Medigap Policy While On Medicare

As you turn 65, you have a variety of decisions facing you. You probably know you need to choose some sort of Medicare plan. What you may not know is that if you go with Original Medicare rather than a Medicare Advantage plan, you may need to get a Medigap policy, also known as a Medicare Supplement Insurance plan, to reduce your out-of-pocket health care expenses.

You can spend thousands of dollars a year if you rely only on Medicare Part A and Part B for your health insurance. You may still have union or employer health care coverage for these expenses but many do not. Medigap plans cover the coinsurance, copayments and deductibles for Medicare Parts A and B and, depending on the plan you choose, other expenses not covered under Medicare such as care in a skilled nursing facility, excess charges if you prefer a doctor who does not accept Medicare assignment, and medical emergencies while you are traveling out of the country. Plan options range from A to N, each one offering various mandated basic coverage so you can buy the plan that fits your health situation.

To optimize your choices, sign up during the six-month period beginning the first day of the month you turn 65. Enrolling after this period, known as the open enrollment period, can cost you more money and limit your options unless you are waiting until you sign up for Medicare B. In that case your open enrollment begins when you sign up for Medicare B. Once you’ve signed up for a plan, you can only change plans annually during Open Season or in special circumstances such as the twelve-month window to change from Medicare Select to a regular Medigap plan.

You and your spouse may have been covered under the same health insurance plan up to now, but you can each choose separate plans since Medigap, like Medicare, only covers individuals. Premiums are in addition to Medicare Part B, and although the plans are standardized by law, prices vary among companies and states. You will want to research your options and decide what coverage you need. You may not obtain a Medigap policy if you have a Medicare Advantage plan, so report to your state insurance department anyone trying to sell it to you.