Do I Really Need Supplemental Insurance With Medicare?

Medicare Supplemental insurance, also known as a Medigap plan, is a form of insurance created to help supplement the cost of Original Medicare. It helps to cover some of the gaps that Medicare Part A and Medicare Part B do not cover, such as deductibles, coinsurance, and copayments. It is essential for many beneficiaries.

A Medigap policy can also cover emergency medical services while traveling outside the United States. It can offer more benefits to Medicare beneficiaries as it helps cover out-of-pocket costs that typically come with Original Medicare plans. Overall, there are many ways a Medigap policy strengthens the coverage of those who choose to enroll.

Why Is Supplemental Insurance Important?

Medicare Supplement insurance, also known as Medigap, plays a significant role in covering expenses not included in Original Medicare, such as copayments, coinsurance, and deductibles. This additional coverage is crucial for providing financial security to individuals during unexpected situations or health issues.

Without supplemental insurance, beneficiaries would have to bear the cost of deductibles for Medicare Part A and Part B and the 20% coinsurance left behind. It’s important to note that the 20% responsibility has no out-of-pocket maximum, which can lead to significant financial strain on the beneficiary.

Medicare Supplement Insurance acts as a safety net, ensuring beneficiaries can access necessary medical services without undue financial hardship.

Benefits of Supplemental Insurance

Medicare Supplement plans offer many perks:

  • Coverage for out-of-pocket costs: These plans can cover certain costs that Original Medicare doesn’t.
  • Travel coverage: If you travel frequently, some Medicare Supplement plans offer coverage for health care services needed outside of the U.S.
  • No referrals needed: Unlike many managed care plans, with Medicare Supplement plans, you typically do not need a referral to see a specialist.
  • Coverage is automatically renewable: As long as you pay your premium, your Medicare Supplement policy is renewable, meaning it automatically renews yearly.
  • Choice of doctors: You can visit any doctor or hospital that accepts Medicare patients.

Remember, benefits may vary based on the specific plan chosen. Always refer to the plan’s detailed description for accurate information.

When Can I Get Supplemental Insurance?

It is highly recommended to consider enrolling in supplemental insurance while signing up for Medicare during the Initial Enrollment Period, which lasts from three months before to three months after your 65th birthday. This is the best time to enroll in Medicare Supplemental insurance because you are not required to undergo medical underwriting.

Applying during this period means you cannot be denied coverage due to preexisting health conditions. Also, you cannot be charged a higher premium for any reason.

Your health status is another factor to consider. If you have existing health conditions or require frequent healthcare services, using this enrollment period to purchase supplemental insurance may be necessary to guarantee coverage. This can help reduce out-of-pocket costs as well. 

Choosing the Right Medigap Policy

Consider factors such as premium costs, level of coverage, and insurance company rating when choosing a policy. The most popular plans are as follows:

  • Plan G is for those seeking the most comprehensive coverage.
  • Plan N is for those seeking a great mix of budget-friendly premiums and coverage.
  • High Deductible Plan G is for those looking for the most affordable premiums while still having the protection of out-of-pocket maximums.

Work with an insurance agent specializing in Medicare insurance to help navigate the selection process.

Bottom Line

While Original Medicare coverage can be adequate for some seniors, it doesn’t cover everything, which can result in significant out-of-pocket expenses. This is why many recommend purchasing a Medigap plan along with Original Medicare. Supplemental insurance is a great way to get additional coverage to protect your health and finances.

When considering supplemental insurance, it’s important to consider factors such as your health status, budget, and healthcare needs.

Take the time to research different policies and work with an insurance agent to ensure you get the proper Medigap insurance policy to meet your needs. 

Sources: Medicare.govCMS.govCenter for Medicare Advocacy


Mark Prip

Since 2003, Mark Prip has been leading  Policy Guide, Inc., providing knowledgeable information about Medicare, life insurance, and dental coverage to clients in over forty states. With his unparalleled hands-on experience aiding countless Medicare beneficiaries in selecting an appropriate health plan, he is a prime example amongst other competitors for expertise and assistance. Mark has held his Florida Health & Life Insurance License (E051889) since 2003. View his license profile on the Florida Department of Insurance website.