Medicare Supplement Plan, how does it work?

Medicare supplement plans or Medigap plans absolutely play the role of supplementing the Traditional Medicare benefits. These policies are known as Medicare Supplement Plans. However, you must have Original or Traditional Medicare enrolment to qualify for Medigap coverage and there is a requirement to stay enrolled in the Traditional Medicare for the medical and hospital coverage. The Medigap plans are not totally focused towards providing stand-alone benefits.

Few things to consider

  • The foremost about the Medicare supplement plans coverage is based on the state you are presently living in, the coverage may or may not be available for various reasons. This includes if you have not attained 65 years, have disability, amyotrophic lateral sclerosis, or end-stage renal disease. The states are not mandated to provide Medigap coverage to under 65 as beneficiaries. In case you are not enrolled in Traditional Medicare and are under 65 years, you may check with the insurance department of the state to find if you qualify for Medicare supplement plans enrolment.
  • Bear in mind that Part D is not included in the Medigap plans as it offers the coverage of prescription drug. Thus, if you are looking for medication costs, you may enroll as a Medication prescription stand-alone drug plan. Apart from this, you may use your Medigap to pay for the costs. The Medigap insurance covers the Original Medicare costs.
  • If there is original Medicare and also the Medigap, the first amount will be paid by Original Medicare and the cost gaps will be paid by the Medigap, the Medicare supplement plans. For instance, you have an ambulance bill of $5000 and the Part B Medicare deductible is already met means the Medicare Part B pays 80% ambulance bill. In case Medicare Supplement plans cover coinsurance and copayments costs part B, then Medigap policy pays 20% remaining coinsurance of ambulance bill for $5000. In fact, some may cover the deductible of Part B as well.

The coverage premiums and levels vary, but the benefits within a lettered category of each plan remain the same regardless of the location. For example, the benefits of Plan A are the same in Oregon and in New Jersey. In case a Medicare Supplement plan comprises of a certain benefit, it is 100% covered benefit, unless or otherwise specified.


Medicare Supplement plans some also cover:

  • Medicare Part A and B deductible
  • Skilled nursing facility care coinsurance
  • Foreign travel emergency as per plan limits