What You Need to Know
Medigap policies help to pay some of the healthcare expenses that you’re responsible for with Original Medicare, like copayments, coinsurance, and deductibles.2
To qualify for a Medigap policy, you must be enrolled in Medicare Part A and Part B.3
You’re guaranteed to be able to renew your Medigap policy even if you have health conditions, so as long as you pay your premiums, you can keep your policy.4
Medigap policies are Medicare Supplement insurance that helps to cover some of the expenses that you’re responsible for when you’re enrolled in Original Medicare, which is Medicare Part A and Part B combined.1 With Original Medicare, you still have copayments, coinsurance, and deductibles, and those can add up. A Medigap policy offers extra coverage to help you pay for those costs.
Private companies sell Medigap policies. When you enroll in a Medigap policy, your Original Medicare will pay the amount that’s approved for your healthcare. Next, your Medigap policy pays its approved amounts toward those remaining costs. This can save you money, especially if you have frequent healthcare needs.
When Can You Enroll in Medigap?
You can enroll in Medigap both during and outside of the Medigap Open Enrollment Period.5 If you buy during the six-month Medigap Open Enrollment Period, you may be able to choose from more policies and qualify for better prices. This period starts the month that you turn 65 and are enrolled in Medicare Part B, and it automatically goes into effect. During this enrollment period, you can buy any Medigap policy available in your state, regardless of whether you have health problems.
You may be able to enroll in Medigap outside of that enrollment period, but it can be more difficult to get a policy. If you’re trying to buy a policy outside of Open Enrollment, insurance companies can deny you if you have health problems. A company can also make you wait for up to six months for coverage if you have a pre-existing condition, and coverage for that specific condition might be excluded.
In some situations, you may have guaranteed issue rights which require insurance companies to offer you Medigap policies outside of Open Enrollment. Many of these rights involve situations where your existing health coverage changes, such as if you move outside of your current Medicare Advantage Plan’s service area.6
Certain circumstances will also qualify you for a Special Enrollment Period (SEP).7 These types of qualifying events include moving, losing your current coverage, having the opportunity to enroll in coverage through your employer, and more. During a SEP, you can change your coverage, but the types of changes you can make will depend on the reason for your SEP.
What Are the Most Popular Medicare Supplement Plans?
You can choose from 10 standardized Medigap policies, each offering slightly different coverage.8 Some of the most popular policies are Plan F, G, and N. Note: Plans C and F are not available to anyone who qualified for Medicare after January 1, 2020.
Plan F
The most comprehensive supplement plan available, Plan F includes coverage for:
- Part A coinsurance and hospital costs
- Part B copays/coinsurance
- Blood (first 3 pints)
- Part A hospice
- Skilled nursing facility
- Part A deductible
- Part B deductible
- Part B excess charges
- Foreign travel emergency – 80%
Plan G
Plan G offers all of the same coverage as Plan F, except it excludes the Part B deductible:
- Part A coinsurance and hospital costs
- Part B copays/coinsurance
- Blood (first 3 pints)
- Part A hospice
- Skilled nursing facility
- Part A deductible
- Part B excess charges
- Foreign travel emergency – 80%
Plan N
Plan N offers the same coverage as Plan F, but it excludes the Part B deductible and Part B excess charges:
- Part A coinsurance and hospital costs
- Part B copays/coinsurance
- Blood (first 3 pints)
- Part A hospice
- Skilled nursing facility
- Part A deductible
- Foreign travel emergency – 80%
How to Choose a Medicare Supplement Plan?
Each Medigap policy offers slightly different coverage and different premium costs. Think about the types of health care costs that you most often face each year and look for a policy that covers those types of costs. You’ll also want to make sure that the policy you choose has a premium that you can afford, and that the costs you’ll save money on will exceed what you’re paying for the policy’s premium.
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How Much Do Medigap Policies Cost?
Medigap policies vary in cost and coverage. For a rough idea, the following costs are for a 65-year-old female in Georgia who doesn’t use tobacco:9
| Plan | Premiums |
| Plan F | from $141 to $421 |
| Plan G | from $113 to $291 |
| Plan N | $90 to $209 |
What If You Want to Change Your Medigap Policy?
It’s important to carefully choose a Medigap policy that works best for you, because you’ll have limited opportunities to change your policy after selecting one.10 Federal law does not grant you the right to switch your policy unless you’re still within your open enrollment period, or you have a special circumstance or guaranteed issue right that makes you eligible.
If you are eligible to change your policy, you’ll need to call the new insurance provider and apply for that new policy. Once your application is approved, you can call your existing policy provider and cancel that policy. The first 30 days that you’re enrolled in a new Medigap policy are considered a “free look period.” You can be simultaneously enrolled in your new and your old policy during this time, as long as you pay the premiums for them both. This gives you a chance to test out your new policy and make sure that you want to keep it before cancelling your old policy.
What Are Alternatives to Medicare Supplement?
If you’re looking for additional coverage but don’t think that a Medigap policy is right for you, you might consider a Medicare Advantage Plan instead. Medicare Advantage Plans help to cover all of your Part A and Part B benefits. Many of these plans offer prescription drug coverage, which Medigap policies don’t provide.11
Medicare Advantage Plans are provided by private companies, and the plans are often structured as four main types:
- Health Maintenance Organization (HMO)
- Preferred Provider Organization (PPO)
- Private Fee for Services (PFFS)
- Special Needs Plans (SNPs)
What Are Medicare Resources in Georgia?
- The GeorgiaCares State Health Insurance Assistance Program (SHIP) provides free counseling services that can help you to understand your Medicare plan options, enroll in a plan, access Medicare out-of-pocket expense financial assistance programs, and more.
- The Georgia Department of Insurance works to answer insurance-related questions and help resolve disputes between you and your insurer.
- Georgia Medicaid provides Georgians with many different programs, including programs that can help you to afford Medicare. This site can also help you to find a local office for additional assistance.
Next Steps
While Medicare pays for most of your health costs, it doesn’t cover everything. Investing in a Medigap policy can give you additional coverage to help reduce your out-of-pocket health costs throughout the year. With many different policies available in Georgia, you’ll need to consider the types of health costs that you face most often when choosing the Medigap policy that’s right for you. For more guidance, check out How to Choose a Medicare Supplement Plan.
