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    Learn About Health Insurance

    Medigap - Medicare Supplement Coverage

    Medicare supplement insurance, sometimes called Medigap, is private insurance that fills in the gaps left by Medicare. For instance, when you have a hospital or doctor bill, Medicare pays its approved amount first, then the supplemental insurance pays other costs, such as deductibles and copays.

    Understanding Medigap Plans

    How Does it Work?

    When you have a healthcare expense, Medicare (Parts A and B) will pay Medicare-approved amounts first, then the Medigap or Medicare Supplement plan will pay its part.

    The Basics

    • The terms 'Medicare Supplement plan' and 'Medigap plan' are used interchangeably and mean the same thing.
    • Medigap is private health insurance designed to help pay healthcare costs that aren’t covered by Medicare.
    • There are different types of Medicare supplement plans. Each plan type is identified by a letter. A, B, C, D, F, G, K, L, M and N are the most common.
    • The cost of a Medicare supplement plan is determined by the plan benefits and coverage amounts.  The more that is covered, the more expensive that plan type will be.
    • You and your spouse must purchase individual policies. Your policy will not cover your spouse.
    • You must have Medicare Parts A and B to purchase a Medigap policy.
    • If you have a Medicare Advantage Plan, also known as Medicare Part C, you cannot purchase a Medigap policy.

    What Won't a Medigap Policy Cover?

    As with any insurance policy, review the policy language closely so you understand what is or is not covered. Generally, Medigap policies don’t cover: long-term care, vision or dental care, hearing aids, eyeglasses, private-duty nursing and prescription drugs.

    Prescription drug coverage is available under Medicare (Part D). Prescription drug benefits are included in some Medicare Advantage plans but otherwise must be purchased separately. 

    When is the Best Time to Get a Medigap Plan?

    The best time to buy a Medigap policy is during your Medigap Open Enrollment Period. Your Medigap Open Enrollment Period is a 6 month period that starts the first month you have Medicare Part B and you’re 65 or older. This is a one-time enrollment period; and will not repeat every year.

    If you don't buy a Medigap policy during your Medigap Open Enrollment Period, you may have to pay more for a policy, have fewer policy options available to you, and there’s no guarantee an insurance company will sell you a Medigap policy.

    Shopping for a Medigap Plan

    PA MEDI - Get Free Unbiased Help and Advice!

    Pennsylvania Medicare Education and Decision Insight, also known as PA MEDI, is a statewide service operated by the Pennsylvania Department of Aging and is the known and trusted local resource for Medicare help. All services are free and confidential.

    Get Started with PA MEDI

    Need More Help?

    If you need more help with Medigap, Medicare or have any other insurance-related questions or issues, our Consumer Services Bureau can help! Visit our Need Help page.