Questions to Consider Before Choosing a Medigap Policy

If you are considering a Medigap policy, find out the answers to these questions before you purchase a policy:

  • Do you need a Medigap policy or are you eligible for a program that helps cover costs for people with low income?
  • Do you have a Medicare Advantage (MA) plan? If so, you can’t use a Medigap policy while you are in an MA plan.
  • Do you want to see any doctor or specialist who accepts Medicare or are you willing to be restricted to a network of doctors, hospitals and other providers in certain MA and Medicare SELECT plans?
  • How much can you afford to spend on monthly Medigap premiums? How does that compare to the premiums and copayments you might have in an HMO, PPO, PFFS, MSA or Medicare SELECT plan?
  • What is the premium for the plan? Note: While their premiums may vary, all policies with the same letter (all plans A or L) cover identical benefits, no matter which insurance company sells them.
  • How might your costs change in the future?
  • What benefits do you need? Note: If you can pay some predictable costs yourself, such as the Part B deductible, you most likely won’t need a plan that covers those costs.
  • Is there a waiting period to cover pre-existing conditions? If so, how long is it? Do you have any previous coverage that may reduce or eliminate the waiting period?
  • Does the insurer file claims electronically? Insurers that accept electronic claims directly from Medicare make it easier and often faster for you and your doctors to receive payment. Note: Doctors who do not accept assignment are not required to file Medigap claims for you. Learn more about Medicare assignment.

For information on choosing between a Medicare Advantage plan and a Medigap policy, see Differences Between Medicare Advantage (MA) Plans & Medigap Policies.