Who Should Buy Medigap?

Not everyone is a candidate to buy a Medigap policy

Choosing to insure with Medicare potentially leaves you open to some  unpredictable costs. Many people automatically assume that they need a Medicare supplement, also known as a Medigap policy.

But buying Medigap is not for everyone, although it is a good solution for people who meet certain criteria.

The following video outlines times when it’s advantageous to buy Medigap.

Is a Medigap policy right for you?

If you have decided that Medicare by itself is not enough, you have two options. You can buy a Medigap policy or enroll in a Medicare Advantage plan.

Medigap is popular because:

  • Plans are standardized
  • Comparing plans and companies is easy
  • You have the freedom to choose your own providers
  • Not subject to annual enrollment

But Medicare supplement premiums are out of reach for many people and there are times when applicants are subject to medical underwriting. Buying a policy is not always guaranteed.

Here are times when you should consider a Medigap policy

The following list is predicated on you being able to afford the premiums. Remember that when you have a Medicare supplement you must continue to pay your Part B premium and Part D is not included.

You should consider:

  • Medigap premiums
  • Part B premium
  • Part D premium

Medigap Open Enrollment

The best time to buy a Medicare supplement is during your Medigap Open Enrollment Period. You cannot be denied coverage, cannot be charged more due to a health condition and will not need to wait for coverage to be effective in most cases.

Your open enrollment period lasts 7 months and begins on the 1st day of the month that you are both 65 and enrolled in Part B.

Submit your application a month or two before your Medicare is effective so both plans will be effective at the same time.

If You want predictable costs

If knowing ahead of time what healthcare expenses you will incur is important to you, consider Medigap.

With original Medicare you know what the Part A deductible amounts may be but being subject to the 20% outpatient coinsurance expense is a real crap shoot.

Also, with a Medicare Advantage plan, deductibles, coinsurance and copayments can vary depending on what services are required. Although plans have a Maximum out-of-pocket expense, knowing how much you will have to pay is hard to determine ahead of time.

It’s just easier to calculate your annual costs with a Medicare supplement.

If you like more certainty

If you don’t want to be subject to your plan changing terms and conditions and possibly the provider network,  consider buying Medigap.

Companies can discontinue a medicare Advantage plan in certain service areas, which can leave you scrambling to find new coverage.

Unless a company that offers Medigap cancels all plans within your class (very unlikely), you cannot be canceled and will continue to be insured as long as you continue to pay your premiums.

Keep in mind that a Medicare supplement is an insurance policy and premiums can increase over time.

Freedom to choose

If you find the idea of using network providers to be unacceptable, consider Medigap. With the exception of a Medicare Select policy (which makes up a small percentage of all Medigap policies), you will be able to choose any provider that accepts Medicare.

If you are a Snowbird or travel frequently, owning a Medicare supplement can eliminate hassles and give you piece of mind.

These are the most popular reasons to buy a Medigap policy.


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