What is Supplemental Health Insurance and Do I Need It?

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What Is Supplemental Health Insurance?

Supplemental health insurance is any healthcare plan that gives you additional coverage beyond the minimum medical coverage. For example, supplemental health policies can provide coverage for things like critical illness, long-term care, cancer, short-term care, accidental death or dismemberment, and more. These supplemental health insurance plans help pay the costs of medical expenses that are not covered by basic insurance plans. They also help with expenses accrued from copays, coinsurance, and deductibles.

Medicare can be confusing for everyone, even for those who have been enrolled in the program for years. We’ll help answer basic questions you may have about supplemental health insurance and give you insight into how you can purchase supplemental health insurance while you are enrolled in Medicare.

What Supplemental Health Insurance Is Available to Those on Medicare?

General supplemental health insurance policies are sold through private companies and are available to any individual who has a health insurance plan. However, if you are 65 or older or are under the age of 65 but still meet the qualifications for Medicare, you qualify for supplemental health insurance under Medicare called Medigap. Medigap is a special program reserved for those on the Original Medicare plan.

What Is Medigap?

It is one of the most common types of supplemental health insurance plans. It can be sold by private insurance companies, but it is reserved for individuals who are enrolled in the Original Medicare plan (Part A and Part B).

Part A and Part B pay for several health-related services, but they do not cover all health-related costs, including some copayments, coinsurance, deductibles, preventative care, nursing-home services, medical supplies, and more. Medicare Supplement insurance will cover the “gaps” that Part A and Part B do not cover.

How Do I Know If I Should Purchase Medigap?

Many users of Medicare wonder whether or not they should invest in Medigap. The answer to that question depends on your individual situation. Deciding whether or not you will benefit from this coverage depends on factors like your overall health and how much you can afford for medical expenses, including insurance.

For example, if you have poor health and know you may need long-term care down the road, then you may be a good candidate for Medicare Supplement insurance. Similarly, if you have little savings but know you will have a large amount of medical expenses, this health coverage may help you offset the costs of future bills. After all, if you are in the hospital for an extended period of time without this coverage, your bills can pile up and become quite expensive, even if you have a large savings account.

Can I Purchase Medigap If I’m on a Medicare Advantage Plan?

No, you cannot purchase a Medigap plan if you are already on a Medicare Advantage plan. In fact, it is illegal for an agent to sell a Medicare Supplement plan to someone on a MA plan. If you decide to drop your Original Medicare plan and purchase a MA Plan instead, then you may want to contact one of our insurance agents to help you cancel your Medigap policy.

Similarly, if you are canceling your MA plan to enroll in the Original Medicare (Part A and Part B) plan, then you may also want to speak with an insurance agent to purchase a Medigap plan. The main thing to remember is if you are on MA, you don’t need Medigap. You may need it only if you are on the Original Medicare plan. You can apply for it while you are on a MA plan; just make sure you leave the Medicare Advantage plan before your Medigap coverage starts.

Where Do I Buy a Medigap Policy?

You can get a Medigap plan from any private insurance company. Just make sure that you purchase this health coverage policy from an insurance agent who is licensed to sell it in your state.

It’s also important to remember that when you get a Medigap policy, you should expect to pay the private insurance company a monthly premium for it. This premium is in addition to the premium you pay to Medicare.

What If My Spouse and I Both Want Medigap Policies?

It is possible for you and your spouse to both purchase this health coverage policies. While you may be used to sharing a health insurance policy, it’s important to remember that Medigap works on an individual basis. This means that if you and your spouse both want coverage, you will need to buy separate policies.

What Happens to My Coverage If I Get Ill?

If you fall ill while you are covered under Medigap, you don’t need to worry. Any standard Medicare Supplement insurance policy is guaranteed to be renewable, regardless of any health problems. This means your health insurance company cannot cancel your Medicare Supplement insurance policy if you wish to renew. The only event in which it may cancel your policy is if you fail to pay the premium.

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