What is Medigap (Medicare Supplement)?

Medicare Supplement plans, also known as Medigap, are available to help cover the gap in Original Medicare coverage. This typically includes copayments, deductibles and the 20% coinsurance left after Medicare covers 80% of costs. Some Medigap policies also include additional services, such as medical care outside of the United States.

Check your particular Medigap policy closely, as coverage may vary based on the supplemental plan. Most help pay for copayments, coinsurance and other services. Some may also cover routine checkups, Medicare deductibles, at-home recovery, and more.  Medicare Supplement plans do not include prescription drug coverage, so you may want to add a Part D plan to complete your medical coverage.

Blue Cross and Blue Shield of Alabama offers Medicare Select Plans which are Medigap policies that cover the cost of services within a select network of healthcare providers. These Medicare C Plus plans cover Medicare-eligible hospital deductibles, copayments, deductibles for physician and outpatient services, the 20% coinsurance for Medicare-eligible physician and outpatient services, and more.

 

Who can apply for Medigap?

Medicare Supplement plans are available to anyone who is currently enrolled in both Medicare Part A and Medicare Part B, also known as Original Medicare. When you enroll within six months of your 65th birthday, anyone is eligible for a Medigap policy.

You can enroll in a Medicare Supplement plan, if:

  • You have Medicare Part A and Part B
  • You do NOT have Medicare Advantage
  • You do NOT have Medicaid

After your initial open enrollment period, not everyone is eligible for a Medicare Supplement at any time. Depending on when you apply, what other coverage you've had, and your medical conditions, the terms and eligibility for a particular policy may vary.

 

Why would I need Medigap?

You may choose to apply for Medigap coverage if you want to control your costs by paying for a Medigap policy that would cover some or most of your out-of-pocket costs left after Original Medicare. For example: Medicare pays 80 percent of your doctor bill and you are left with 20 percent. Medigap pays the 20 percent and you pay nothing.

Medigap is not a replacement for Original Medicare and is only available if you already have both Part A and Part B coverage. A supplemental Medicare policy does not cover prescription drugs (Medicare Part D), or additional benefits like vision, hearing or dental care that you might receive from a Medicare Advantage plan. If you are enrolled in a Medicare Advantage (Part C) plan, you do not need a Medigap policy.

All of our Medicare Supplement plans include:

  • myBlueCross – 24-hour online access to your personal health information, easy-to-use online tools and a mobile app for access on the go
  • The extensive provider network – 98% of hospitals in Alabama, plus doctors and specialists in every county
  • Nationwide network of pharmacies – coverage for a wide range of Medicare-approved drugs at more than 63,000 pharmacies
  • No-cost preventive services – preventive screenings and immunizations covered at no cost to you
  • 24-hour Nurse Hotline – specially trained nurses standing by to answer your questions, 24 hours a day, 365 days a year
  • A FREE SilverSneakers® by Tivity Health fitness membership*– a fun and innovative health, exercise, and wellness program designed specifically for Medicare-eligible adults to help you get fit while making new friends and enjoying a healthy lifestyle
  • AirMed transportation service** – air ambulance transport if you are hospitalized more than 150 miles from home to get you to a hospital near your home

When do I enroll in a Medicare Supplement plan?

There is an Open Enrollment Period for a Medicare Supplement plan (Medigap) when you first turn 65. Beginning on the first day of the month of your 65th birthday, you have a six-month window to apply for a Medigap policy. Or, if you sign up for Medicare Part B at another time, you have within six months to select a Medigap policy.

During this initial Open Enrollment Period, you will receive the best possible rate for your Medigap policy, regardless of medical condition. At this time, you also cannot be denied for a pre-existing condition. However, after your six month enrollment window closes, your Medigap rates may increase, and coverage for any pre-existing conditions may be delayed for up to six months.

Medigap policies are guaranteed renewable, which means you can continue with your same Medigap policy unless you stop paying your premium, were untruthful on your application, or the insurance company becomes bankrupt or insolvent.

Unlike Medicare Advantage plans (Part C), Medicare Supplement plans are not part of Medicare. These plans are provided by private insurers like Blue Cross and Blue Shield of Alabama. Choose your Medicare Supplement plan today.

 

* SilverSneakers® Fitness Program is provided by Tivity Health Inc.™ ©2017, an independent company with subsidiaries and affiliates worldwide. All rights reserved.

** Air medical transport services are provided through a contract with AirMed International, LLC. AirMed International, LLC is an independent company that does not provide Blue Cross and Blue Shield of Alabama products. Blue Cross is not responsible for any mistakes, errors or omissions that AirMed, its employees or staff members make. Air medical services terminate if coverage by your health plan ends.