Medigap plans, also called Medicare supplement plans, are private insurance plans designed to work alongside Original Medicare. They can help pay certain expenses that Medicare leaves behind, including deductibles, copayments and coinsurance, often the costs that make routine care or an unexpected hospital stay harder to budget for.
The value of a supplement policy is not that it replaces Medicare, but that it makes your share of approved medical bills more predictable. Coverage varies by plan letter and by insurer, although standardized benefit rules mean similarly named plans generally provide the same core coverage in a given state.
Some supplement plans pay most Medicare-approved cost-sharing; others leave a deductible, a portion of skilled nursing facility coinsurance, or other out-of-pocket costs for the member. Plans may also cover limited emergency care during foreign travel, subject to conditions and lifetime limits.
It is equally important to understand what Medigap insurance does not cover. These policies ordinarily do not include prescription drugs, routine dental or vision care, hearing aids, long-term custodial care, or private-duty nursing.
They also do not pay Medicare Advantage cost-sharing, because Medigap is intended for people enrolled in Original Medicare. Monthly premiums can differ substantially by carrier, rating method, location and age, even when benefits are identical. Compare the premium with the deductible, expected care needs and potential excess charges in your area, not simply the lowest advertised price.