Medicare Supplement (Medigap)

What is Medigap coverage?

Medicare Supplement, also known as Medigap coverage, works with Original Medicare and allows you to see any Medicare provider in the country. In most states, including Oregon, there are no pre-authorization requirements under Original Medicare. Coverage is standardized with plans named Plan A through Plan N, with Plan G and Plan N being the two most popular plans.

What is covers

To simplify: Plan G covers all Part A expenses and the Part B coinsurance, leaving you only with the Medicare Part B deductible ($288 in 2006) to pay out of pocket.

With Plan N, you have the same deductible, but also pay $20 copays to doctors' office visits and $50 for ER. In addition, if you see a provider who does not accept Medicare assignment, you could pay a 15% excess charge with Plan N. Plan G covers this charge. Only about 3% of providers currently do this, but that could change in the future. You can look up those providers here.

Download the Choosing a Medigap Policy document below for more details about each plan.

A few companies include a fitness membership.

What is does not cover

Medigap policies do not generally cover dental, vision, hearing, and alternative care.

Qualifying for Medigap

There are a few ways you can qualify for a Medigap plan without having to go through medical underwriting (answer health questions). Common ones are:

• When you first become eligible for Medicare
• If you have a Medicare Advantage plan and move out of the plan's service area
• If your Medicare Advantage Advantage plan stops offering coverage in your area
• Within the first 12 months of having a Medicare Advantage plan for the first time

If you do not have a "Guaranteed Issue" situation, you would have to answer the company's health questions to qualify. For a general idea of whether you may qualify, review the questions on our pre-qualification page.