Are you looking for Medigap or Medicare Supplement Care Insurance in California?
The experts at Nelson Insurance have over 12 years experience helping families find suitable coverage that meet your needs. We shop multiple companies to find the right solution for you and your family.
What's Medicare Supplement Insurance (Medigap)?
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| Note: Medigap plans sold to people who are newly eligible for Medicare aren’t allowed to cover the Part B deductible. Because of this, Plans C and F aren’t available to people newly eligible for Medicare on or after January 1, 2020. If you already have or were covered by Plan C or F (or the Plan F high deductible version) before January 1, 2020, you can keep your plan. If you were eligible for Medicare before January 1, 2020, but not yet enrolled, you may be able to buy one of these plans that cover the Part B deductible. |
Some Medigap policies also cover services that Original Medicare doesn't cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, here's what happens:
- Medicare will pay its share of the for covered health care costs.
- Then, your Medigap policy pays its share.
8 things to know about Medigap/Supplement policies
- You must have Medicare Part A and Part B.
- A Medigap or Supplement policy is different from a Medicare Advantage Plan. The Supplement fills in the 20% that Medicare doesn't pay. The Medicare Advantage plan is an all encompass plan that has copays and additional benefits beyond Medicare.
- You pay the private insurance company a monthly for your Medigap/Supplement or your Advantage plan policy. You pay this monthly premium in addition to the monthly Part B premium that you pay to Medicare. Once you turn on your Part B premium, you will continue to pay this premium.
- A Medigap/Supplement policy only covers one person. If you and your spouse both want Medigap/Supplement coverage, you'll each have to buy separate policies.
- You can buy a Medigap/Supplement policy from any insurance company that's licensed in your state to sell one.
- Any standardized Medigap/Supplement 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.
- Some Medigap/Supplement policies sold in the past cover prescription drugs. But, Medigap policies sold after January 1, 2006 aren't allowed to include prescription drug coverage. If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D). If you buy Medigap and a Medicare drug plan from the same company, you may need to make 2 separate premium payments. Contact the company to find out how to pay your premiums.
- It's illegal for anyone to sell you a Medigap/Supplement policy if you have a Medicare Advantage Plan, unless you're switching back to Original Medicare.
Medigap policies don't cover everything
Medigap policies generally don't cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.
Insurance plans that aren't Medigap
Some types of insurance aren't Medigap plans, they include:
- Medicare Advantage Plans (like an HMO, PPO, or Private Fee-for-Service Plan)
- Medicare Prescription Drug Plans
- Employer or union plans, including the Federal Employees Health Benefits Program (FEHBP)
- Veterans' benefits
- Long-term care insurance policies
- Indian Health Service, Tribal, and Urban Indian Health plans
Dropping your entire Medigap policy (not just the drug coverage)
You may want a completely different Medigap policy (not just your old Medigap policy without the prescription drug coverage). Or, you might decide to switch to a Medicare Advantage Plan that offers prescription drug coverage.
If you decide to drop your entire Medigap policy, you need to be careful about the timing. When you join a new Medicare drug plan, you pay a late enrollment penalty if one of these applies:
- You drop your entire Medigap policy and the drug coverage wasn't
- You go 63 days or more in a row before your new Medicare drug coverage begin
