What are Medigap plans?

Medigap plans are offered by private insurance companies and are available to individuals who have Medicare Part A and Medicare Part B. Unlike Medicare Advantage Plans, which are primary to Original Medicare, Medicare Supplement Insurance is secondary coverage that helps fill the gaps.

For policies sold on or after June 1, 2010, there are 11 standardized Medigap plans labeled Plan A, Plan B, Plan C, Plan F, Plan G, Plan K, Plan L, and Plan N. Each standardized plan provides the same benefits regardless of the insurer.

Popular options like Plan N and Plan G offer comprehensive coverage, including Part B coinsurance and protection against Part B excess charges. Some plans also include benefits for skilled nursing facility care and foreign travel emergency care.

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Key Features of Medicare Supplement Insurance:

 

  • Doctor Choice: Unlike HMO or PPO plans, you can choose any providers who accept Medicare patients.
  • Convenience: Virtually no claim forms to file.
  • Guaranteed Renewals: As long as you pay your monthly premium on time and meet eligibility requirements.
  • Access to Specialists
    Individuals can see specialists without needing a referral
  • Freedom
    Coverage that travels with you anywhere in the U.S.

Premiums and Enrollment

To enroll in a Medicare Supplement Plan, you must:

  • Have Medicare Part A and Medicare Part B.
  • Continue paying your Part B premium plus your Medigap monthly premium.

Your best time to enroll is during the Medigap Open Enrollment Period—a six-month window starting when you turn 65 and enroll in Part B. During this time, you cannot be denied coverage due to pre-existing conditions or health history. In New York State, regulations require insurance companies to accept applications year-round, making New Yorkers uniquely protected.

Old Couple Discussing On Medicare Supplement Plans New York City

What Does a Supplement Plan Not Cover?

What’s Not Covered

Medigap plans do not include prescription drug coverage. You’ll need a separate Part D plan for medications. They also don’t cover:

  • Out-of-pocket costs with Long-term care
  • Dental or vision care
  • Hearing aids
  • Cosmetic surgery
  • Acupuncture

However, some insurers like Blue Cross Blue Shield or Mutual of Omaha may offer optional coverage options such as fitness programs, dental, and vision add-ons.

Why Consider Plan G or Plan N?

  • Plan G: Covers nearly all gaps except the Part B deductible. Many New Yorkers opt for the high deductible plan G as another alternative.
  • Plan N: Offers lower premiums but may include small copayments for office visits and emergency room care.

For more details, contact our team of licensed insurance agents today at our New York City office near Central Park or, our Long Island office in Melville.