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5 Common Medigap Insurance Myths & Misconceptions

5 Common Medigap Insurance Myths
A Medigap plan, also referred to as a Medicare Supplement plan, is Medicare insurance designed to fill the gaps in coverage left by Medicare's Part A & Part B. Medigap plans are reasonably straight-forward, and with a little effort, are fairly easy to understand. However, most people are misinformed about Medigap plans, which lead to a number of Medigap insurance myths and misconceptions. As a result, people find themselves with the wrong plan. In an effort to clear any confusion, I have outlined 5 common Medigap insurance myths below.

Medigap Insurance Myths


Medicare Advantage plans are the same as Medicare Supplement plans

People place Medicare Advantage and Medigap plans into the same, “Medicare Supplement” category. By comparison, they are actually very different. One, Medicare Advantage plans replace Medicare Part's A & B, whereas, Medigap plans complement or supplement it. Two, Medicare Advantage plans usually will have co-pays and out-of-pocket maximums, while most Medigap plans don't. Learn more about the differences between Medicare Advantage & Medigap plans.


Medigap plans provide prescription drug coverage

As stated above, Medigap plans supplement Medicare Part A (Hospital) & Part B (Medical). However, it does not provide drug coverage. In order to get prescription drug coverage, you must sign up for Medicare Part D. Thus, if you have Medicare Parts A & B and a Medigap plan, you still do not have coverage for your medications. Learn more about Medicare Part D.


You can only change Medigap plans during certain times of the year

This is one of the most popular Medigap insurance myths. For the record, you CAN change Medigap plans at any time of the year, for any reason or to any company or plan. What needs to be understood is that insurance carriers can medically underwrite you, and based on your health, you may get declined. On the contrary, if you are in good health without any pre-existing conditions, you may not have any issues changing plans. In California, there is a rule known as the "Medigap Birthday Rule", which allows Medigap members to change plans up to 30 days following their birthday with guaranteed issue, meaning no medical underwriting. Learn more about California's Medigap Birthday Rule.


You must go to a doctor that "accepts" your Medigap plan

People think their provider needs to be contracted with the Medigap plan they are considering. This is incorrect. Your doctor needs only to accept payment from Medicare. As a result, your provider is required to accept your Medigap plan regardless of the insurance carrier or plan letter. Generally, if they don't accept payment from Medicare, more than likely, they won't accept your Medigap plan. Doctors cannot choose to contract with specific Medigap plans. Ultimately, Medigap plans appeal to those who need coverage out of state or prefer to have broader access to doctors so they are not confined to specific networks.


Medigap plan benefits can vary from carrier to carrier

Medigap plans are federally standardized and do not change from carrier to carrier or state to state in order to protect consumers. For example, Medigap Plan F's benefits are the same at Aetna, Blue Shield, Cigna and so on. The main difference being the premium for these plans. While, one carrier may charge $150 per month for Medigap Plan F, the other may charge $180. It is always a good idea to use a licensed agent to help you find the best Medigap plan at the best price. Note, you will not pay more for using an agent. Learn more about Medigap plans.