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Medigap (Medicare Supplement)

If you are enrolled in Medicare Part A and B (Original Medicare), Medigap plans can help fill the coverage gaps in Medicare Part A and Part B. Medigap plans are sold by private insurance companies and are designed to assist you with out-of-pocket costs (e.g., deductibles, copays and coinsurance) not covered by Parts A and B. These plans are available in all 50 states and can vary in premiums and enrollment eligibility. Medigap plans are standardized; however, all of the standardized plans may not be available in your area.

Costs 

Premium

All Medigap plans require that you continue to pay your Part B premium and a separate premium for Medigap coverage.

Deductible

Some plans have deductibles.

Copays

A copayment may apply to specific services.

Coinsurance

The percentage of coinsurance varies depending on plan.

Limits and Considerations

Limits

Most of the time, Medigap coverage has no network limitations and is available anywhere that Medicare is accepted.

Things to Consider

  • Some Medigap plans cover foreign travel emergency services.
  • Once you are enrolled in a plan, it renews every year as long as you pay your premium and the plan is available.

Initial Enrollment Period

The Initial Enrollment Period is a limited window of time when you can enroll in Original Medicare (Part A and/or Part B) when you are first eligible. After you are enrolled in Medicare Part A and Part B, you can select other coverage options like a Medigap (Medicare Supplement) plan from approved private insurers. The best time to buy a Medigap policy is the six-month period that starts the first day of the month that you turn 65 or older and enrolled in Part B. After this period, your ability to buy a Medigap policy may be limited and it may be more costly. Each state handles things differently, but there are additional open enrollment periods in some cases.

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When to Enroll
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When you are first eligible, your Initial Enrollment Period for Medicare Part A and Part B lasts seven months and starts when you qualify for Medicare, either based on your age or an eligible disability.
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FAQ Item Question
Individuals Aged 65 or Older
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Your Initial Enrollment Period is based on the month in which you turn 65. It begins three months before your birth month and extends until three months after your birth month.

Enrollment Period

Example: If you are born on June 18, 1952, your Initial Enrollment Period is from March 1, 2017 until September 30, 2017.

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Individuals Aged Under 65 with an Eligible Disability
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Your Initial Enrollment Period is based on when you began receiving Social Security or Railroad Retirement Board (RRB) disability benefits. It begins the 22nd month after you began receiving benefits and continues until the 28thmonth after you began receiving benefits.

Monthly Benefits

Example: If you are began receiving disability benefits in January 2015, your Initial Enrollment Period is from November 1, 2016 until May 31, 2017.

How to Enroll

You must first enroll in Medicare Part A and Part B before joining a Medigap (Medicare Supplement) plan. Contact your local Blue Cross Blue Shield company for help choosing a Medigap (Medicare Supplement) plan and getting enrolled.
 

Open Enrollment Period

The open enrollment period for Medicare runs from October 15 through December 7 on an annual basis, however, this is not the case for individuals interested in Medigap (Medicare Supplement) coverage. The open enrollment period for a Medigap policy is the six-month period that starts the first day of the month that you turn 65 or older and enrolled in Part B. After this period, your ability to buy a Medigap policy may be limited and it may be more costly. Each state handles things differently, but there are additional open enrollment periods in some cases.

Note: Once you are enrolled in a Medigap (Medicare Supplement) plan, it renews every year as long as you pay your premium and the plan is available.