What Is Medigap?

Health, Home & Family
on September 27, 2011

One challenge with medical insurance is that the entire cost of claims is not always covered fully by the policy. This happens with people who have private insurance, and it also occurs with government-sponsored insurance plans such as Medicare. Finding adequate coverage is a practical decision, but it also can bring peace of mind to those who are on Medicare. When Medicare does not cover certain medical expenses or does not cover them fully, this is labeled as a “Medigap.”

Filling in the gaps. In order to compensate for this gap and cover expenses completely, consumers can acquire private insurance programs to supplement Medicare. Shopping for these types of programs can be a challenge. However, the government provides a number of resources that help people locate programs in their state.

Searching for plans. Various insurance companies can sell a supplemental insurance policy that is standardized as a Medigap plan. According to the U.S. Department of Health and Human Services, Medigap policies are supposed to be clearly designated as supplement programs. This protects consumers so they do not buy the wrong insurance package.

Rules and regulations. In order to obtain a Medigap policy, consumers typically need to be enrolled in Medicare Part A and Part B. In addition, it is important to understand what the Medigap actually covers. Depending on the year of enrollment, certain coverage may not be provided. The Medigap program is designed for the individual, and each person must get his or her own policy. Consumers are allowed by law to renew these policies as long as they pay their premiums each year.

Understanding the laws. The Medigap policy is designed to shield the consumer, and policy holders have rights under the law. However, consumers should understand the laws of their state when shopping for a policy. Costs can vary from policy to policy, so it is important to read, ask questions and consult policy guides that are provided by the government.