Medigap - Medicare Supplements
Medigap at a Glance: - Medicare Supplement, or Medigap, policies are sold by private insurance companies to fill the gaps left uncovered by Original Medicare (PARTS A & B). These PLANS help pay your share (deductibles, coinsurance, copayments) of the costs of Medicare-covered services. For truly unbiased answers to your senior health issue questions, we encourage you to contact Illinois' Senior Health Insurance Program (SHIP), which is a division of the Illinois Department on Aging. Here is a listing of the SHIP locations as of the beginning of 2021. For the most current listing, go to the Illinois Department on Aging Website and click on the link entitled "Volunteers in Your Area (By County)."
Important Note About Your Coverage - The services that you receive from medical service providers will be covered by Medicare and your Medicare Supplement policy if those services meet two criteria. The services must be "Medically Necessary" and "Medicare Approved." If these two factors are not met, then your charges will not be covered by Medicare or your Medicare Supplement.
Key Factors about Medicare Supplement PLANS
All the Plans are Standardized
- Plans are designated by letters ranging from "A" through "N" and must follow federal and state laws to protect you. The plans are defined at the federal level by the Center for Medicare and Medicaid Services (CMS) and are monitored for compliance by the Illinois Department of Insurance. The most popular Medicare Supplements are Plans F, G and N. Here is an Overview of how these three plans address the charges not covered by Medicare. Note: Plan F is only available to individuals who became eligible for Medicare prior to January 1, 2020.
- Each standardized Medicare Supplement policy must offer the same basic benefits, no matter which insurance company sells it.
- Cost is usually the only difference between Medicare Supplement policies sold by different insurance companies.
- All policies are "individual" policies - there are no "family" or "group" policies, although a few companies offer a "household" discount if spouses / partners are both enrolled.
- Here is a Chart describing the benefits of all the currently available Medicare Supplement plans, and the most recently published booklet "Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare" from CMS.
Enrollment can be Done at Any Time
- Most individuals enroll in a Medicare Supplement plan during their "Open Enrollment" period when they become eligible for Medicare. The Open Enrollment period is defined as a six-month period starting on the Effective Date of Medicare Part B. Individuals who start Medicare Part B prior to age 65 (individuals who are on Social Security disability, for example) have a second Open Enrollment period when they turn 65. During the Open Enrollment period, individuals can apply for any plan at the lowest premium rate from any insurance company, without consideration of medical issues or tobacco use.
- Some individuals enroll in a Medicare Supplement plan during a "Guaranteed Issue" period. These are special time periods that exist under special circustances.
- Individuals can apply for Medicare Supplemente coverage at any time during the year. If the individual is not in an Open Enrollment or Guaranteed Issue period, medical questions may limit which companies will approve an application.
Not All Medical Charges are Covered
- Medicare Supplement Policies address "Approved" charges that are not paid for by Medicare. Not all "medically required" charges are "Approved" as part of the covered charges of Medicare.
- Some examples of medically required charges that are not covered by Medicare (and by extension, are not covered by Medicare Supplement policies) include routine Dental, Vision, Hearing, and Long Term Care costs. Other Insurance policies are available for these areas, and are described elsewhere on this website.
- Other examples of non-covered or partially-covered charges include Chiropractic services, physical therapy, third surgical opinions, health care needed when traveling outside the United States, etc. For more details, review the most recently published official U.S. Government Medicare Handbook "Medicare & You".
Select Medicare Supplement Insurance Companies
The following insurance companies have been carefully selected because of their competitive rates. Over time, the list expands and contracts as new carriers enter the market and as existing carriers' rates become non-competitive.
Accendo -- Aetna Health -- Americo (Great Southern Life)
Blue Cross Blue Shield -- Capitol Life -- Cigna
Central States of Omaha -- Lumico (Elips) -- Omaha Insurance (Mutual of Omaha)
Prosperity Life Group -- ManhattanLife Assurance -- United American -- United States Fire