Who qualifies for Medicare supplemental insurance?
Summary
Medicare provides health insurance for many retired Americans but does not cover all medical costs. Medicare supplemental insurance, called Medigap, can help pay some costs that Medicare does not, but people must meet certain rules to qualify for a Medigap policy.Key Facts
- Medigap helps cover expenses like deductibles and coinsurance that Original Medicare does not pay.
- To buy Medigap, you must have Original Medicare, which includes Part A (hospital care) and Part B (doctor visits).
- You cannot use Medigap if you have a Medicare Advantage plan because those plans replace Original Medicare.
- There is a special six-month enrollment period starting at age 65 when you first enroll in Part B, during which insurers cannot deny coverage or charge more based on health problems.
- After this six-month period, insurers may use medical checks to decide if they will sell you a policy or charge you more, depending on your health and state laws.
- Some people under age 65 with disabilities or kidney failure may also qualify for Medicare but face different and sometimes stricter rules when applying for Medigap.
- Medicare does not have a yearly limit on out-of-pocket costs, so unexpected medical events can lead to high expenses for beneficiaries.
- Medicare premiums and deductibles have recently increased, making the extra coverage from Medigap appealing to many retirees.
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