What is Medigap?

A Medigap policy or Medicare supplement plan is an insurance policy sold by private insurance companies to help fill the gaps in Medicare.

Basically, in exchange for a monthly premium paid to the Medicare supplement insurance company, that company will help cover some or all of the gaps, deductibles and

coinsurance for you.

A Medigap policy or Medicare supplement plan is an insurance policy sold by private insurance companies to help fill the gaps in Medicare.

Basically, in exchange for a monthly premium paid to the Medicare supplement insurance company, that company will help cover some or all of the gaps, deductibles and

coinsurance for you.

There are ten primary Medicare supplement plans to pick from, and they’re all labeled alphabetically. The three most commonly purchased plans are Plan F, Plan G and Plan N. Which plan you choose, or should choose, depends mostly on your budget as well as how much of the 20% coinsurance you want covered.

The plans themselves are standardized, meaning that the benefits are the same from one company to the next for like plans. No company can offer you any additional benefits for any specific plan versus another company for that exact same plan. The benefits are identical and usually the only difference between one company and the

next is the monthly premium they charge you.

There are ten primary Medicare supplement plans to pick from, and they’re all labeled alphabetically. The three most commonly purchased plans are Plan F, Plan G and Plan N. Which plan you choose, or should choose, depends mostly on your budget as well as how much of the 20% coinsurance you want covered.

The plans themselves are standardized, meaning that the benefits are the same from one company to the next for like plans. No company can offer you any additional benefits for any specific plan versus another company for that exact same plan. The benefits are identical and usually the only difference between one company and the

next is the monthly premium they charge you.

It's portable! Where Medicare goes, so does your Medigap plan.

It's portable!

Where Medicare goes, so does your Medigap plan.

What is most important to know, is that a Medicare supplement plan functions much like an extension of Medicare. It travels with you wherever Medicare is accepted, but it will not cover anything that is not already approved and covered by Medicare. In the most general terms, any service that Medicare is paying 80% for, your Medicare supplement plan will pay its portion also. If Medicare doesn’t pay, then neither will your Medicare supplement.

This also means that, just like Medicare, a Medicare supplement plan does not cover dental, vision and hearing, nor does it cover the cost of prescription medications that are obtained through a pharmacy.

What is most important to know, is that a Medicare supplement plan functions much like an extension of Medicare. It travels with you wherever Medicare is accepted, but it will not cover anything that is not already approved and covered by Medicare. In the most general terms, any service that Medicare is paying 80% for, your Medicare supplement plan will pay its portion also. If Medicare doesn’t pay, then neither will your Medicare supplement.

This also means that, just like Medicare, a Medicare supplement plan does not cover dental, vision and hearing, nor does it cover the cost of prescription medications that are obtained through a pharmacy.

Medigap Open Enrollment

When you first enroll into Medicare Part B, regardless of your age, you’ll be given a six-month period known as Medigap Open Enrollment where you can enroll into any Medicare supplement plan you choose and no company can deny you or enforce a preexisting condition clause. Outside of this initial six months you will, except under very limited circumstances, always be subject to approval based on your current health conditions.

This six-month period is often a person’s one shot at getting it right, and another reason why delaying Part B can be a correct choice when you’re already covered by an employer group plan. Otherwise, in addition to the wasted money, you

would also be wasting your single Medigap Open Enrollment Period by not choosing to delay Part B and duplicating coverage.

When you first enroll into Medicare Part B, regardless of your age, you’ll be given a six-month period known as Medigap Open Enrollment where you can enroll into any Medicare supplement plan you choose and no company can deny you or enforce a preexisting condition clause. Outside of this initial six months you will, except under very limited circumstances, always be subject to approval based on your current health conditions.

This six-month period is often a person’s one shot at getting it right, and another reason why delaying Part B can be a correct choice when you’re already covered by an employer group plan. Otherwise, in addition to the wasted money, you would also be wasting your single Medigap Open Enrollment Period by not choosing to delay Part B and duplicating coverage.

Important Points:

You must have Medicare Part A and Part B to enroll into a Medicare supplement plan.
You pay the private insurance company a monthly premium for your Medigap policy. You pay this monthly premium in addition to the monthly Part B premium that you pay to Medicare.
A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you'll each have to buy separate policies.
You can buy a Medigap policy from any insurance company that's licensed in your state to sell one.
Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can't cancel your Medigap policy as long as you pay the premium.
If your Medicare Part A is effective on or after January 1, 2020, you will not have the option to purchase Medicare supplement Plans C or F. Plans A, B, D, G, K, L, M & N are still available.

You must have Medicare Part A and Part B to enroll into a Medicare supplement plan.
You pay the private insurance company a monthly premium for your Medigap policy. You pay this monthly premium in addition to the monthly Part B premium that you pay to Medicare.
A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you'll each have to buy separate policies.
You can buy a Medigap policy from any insurance company that's licensed in your state to sell one.
Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can't cancel your Medigap policy as long as you pay the premium.
If your Medicare Part A is effective on or after January 1, 2020, you will not have the option to purchase Medicare supplement Plans C or F. Plans A, B, D, G, K, L, M & N are still available.

This is a proprietary website and is not associated with, endorsed, or authorized by Medicare or the federal government.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

DBA "Avila Medicare Solutions"

1903 Cypress Creek Road, Suite 102

Cedar Park, Texas 78613

Texas Lic. No. 2951709

California Lic. No. 6009869