Medigap

💡 What Is Medigap?

Medigap (also called a Medicare Supplement Insurance plan) is extra insurance you can buy from a private company to help pay the “gaps” in Original Medicare.

These gaps are things like:

• Deductibles (the amount you pay before Medicare starts paying)

• Coinsurance (usually 20% of the bill)

• Copayments (fixed amounts you pay for services)

So: Medicare pays most, Medigap helps pay the rest.

🏗️ How It Fits In

Here’s how it works together:

1. You have Original Medicare (Parts A and B)

2. You buy a Medigap plan (optional) from a private insurance company

3. When you go to the doctor or hospital:

   • Medicare pays its share (usually 80%)

   • Medigap pays some or all of the rest (depending on the plan)

   • You pay little or nothing out of pocket

🚫 What Medigap does NOT cover:

• Prescription drugs (you’d need a Part D plan for that)

• Long-term care

• Vision, dental, or hearing

• Private-duty nursing

📘 Real-Life Example:

Let’s say Alice is 68 and has:

• Original Medicare (Part A and B)

• Medigap Plan G (a common type of Medigap)

Alice goes to the hospital for a short stay:

• The bill is $10,000

• Medicare Part A pays most of it, but Alice owes $1,600 as a deductible

💰 Because she has Medigap Plan G:

• Her Medigap plan pays that $1,600 for her

• Alice pays nothing out of pocket

📝 Important Notes:

• You must have Original Medicare to get a Medigap plan.

• You can’t use Medigap with Medicare Advantage — it only works with Original Medicare.

• There are different types of Medigap plans (Plan A, B, G, N, etc.), each offering different levels of coverage.

🟢 In Simple Terms:

Medigap = backup insurance that helps cover the bills Original Medicare doesn’t fully pay.