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Medigap

By Amal Trivedi, MD, MPH, Associate Professor, Department of Health Services, Policy and Practice and Department of Medicine, Brown University

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Medigap is supplemental insurance designed to pay for medical care not covered by Medicare, including the deductibles and co-payments required by Medicare and extra charges by doctors who do not accept Medicare as full payment for a service. To obtain a Medigap policy, people must be enrolled in Medicare parts A and B and must not be enrolled in Medicare Part C (Medicare Advantage). Medigap policies do not duplicate payment for services covered by Medicare Parts A and B. The best time to purchase Medigap insurance is during its enrollment period, which begins when Medicare Part B is purchased and ends 6 months later. At other times, Medigap may be unavailable or more expensive. Many insurance companies offer Medigap insurance.

There are 14 types of Medigap policies, labeled A through N. Each type offers a different set of benefits. But the benefits of a specific type are the same no matter which insurance company offers it. Generally, Medigap policies do not cover payment for long-term personal care (at home or in a nursing home), vision or dental care, hearing aids, private-duty nursing, or all prescription drugs. However, additional insurance policies that cover such services can be purchased.