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What Is Medicare Supplement Insurance?

Medicare Supplement Insurance - medical concept

A Medicare Supplement Insurance policy—often referred to as a “Medigap plan”—is a kind of insurance policy sold by a private company that helps beneficiaries pay some of the healthcare costs that are not covered by Original Medicare. Unlike a Medicare Advantage plan, which takes the place of Original Medicare (Parts A and B), a Medicare Supplement Insurance policy works in conjunction with Original Medicare. In fact, in order to enroll in a Medigap plan, you must already have Original Medicare.

How Does a Medicare Supplement Plan Work?

When a beneficiary has Original Medicare and a Medigap plan, and they incur healthcare-related expenses, Original Medicare will first pay its share of the cost, and then the Medicare Supplement Insurance will pay what is left, essentially filling in “the gap” in coverage—hence the term Medigap plan.

What Does a Medicare Supplement Plan Cover?

Because Original Medicare typically only covers hospital stays (Part A) and physician fees (Part B), Medicare Supplement Insurance policies can help cover the cost of copayments, coinsurance, and deductibles. Some Medicare Supplement plans also provide healthcare coverage while a beneficiary is traveling outside of the United States, which is something the Original Medicare does not cover.

What Does a Medicare Supplement Plan NOT Cover?

Just as important as knowing what a Medicare Supplement policy covers is knowing what expenses it does not cover. Medigap plans don’t typically cover long-term care, vision care, dental care, hearing aids, eyeglasses, or private-duty nursing services. Also, Medigap plans do not cover prescription drugs. While some Medigap plans sold in the past did include prescription drug coverage, since Medicare Part D was introduced on January 1, 2006, Medigap plans are no longer allowed to cover prescriptions. For prescription drug coverage, a beneficiary must either add Medicare Part D to their existing coverage or enroll in a Medicare Advantage plan that includes a Medicare Part D component.

Get Started Today

If you would like more information about how a Medicare Supplement Insurance policy can help your clients fill in the gaps in their healthcare coverage, enroll in our Medicare Products training course. Or, to learn more about contracting with MCC Brokerage, contact us today.

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