Medicare Supplement plans, also called Medigap plans, work with Original Medicare to help cover certain out-of-pocket health care costs, including copayments, coinsurance and deductibles.
What is a Medicare Supplement, or Medigap, plan?
A Medigap plan, also known as Medicare Supplement Insurance, is a policy offered by private insurers to help cover some of the healthcare costs that Original Medicare (Parts A and B) doesn't cover. These costs can include copayments, coinsurance and deductibles.
To be eligible for a Medigap plan, you must be enrolled in Original Medicare (Parts A and B).
What does a Medicare Supplement Plan help pay for?
Medicare Supplement plans can help pay for certain out-of-pocket costs that Original Medicare doesn’t cover, such as:
- Copayments
- Coinsurance
- Deductibles
Medigap plans are designed to work alongside Original Medicare and may help reduce what you pay when you receive medical care.
Medicare Supplement vs. Medicare Advantage: What’s the difference?
Both Medicare Advantage and Medigap are coverage options that can help enhance Original Medicare, but they work differently.
| Feature | Medicare Supplement, or Medigap | Medicare Advantage |
|---|---|---|
| How it works | Works alongside Original Medicare | Works similarly to individual or employer HMO or PPO plans |
| Out-of-pocket costs | Helps cover most or all of the costs Original Medicare doesn’t cover | Helps lower costs with predictable copayments, smaller deductibles and out-of-pocket costs |
| Doctor choice | You can see any doctor who accepts Medicare | You can save money by seeing doctors within the plan’s network |
| Prescription drug coverage | Not included; you need a separate Part D plan | May include prescription drug coverage, depending on the plan |
| Can you have both? | No | No |
Important: Medicare Supplement and Medicare Advantage plans do not work together. If you have a Medicare Advantage policy, you cannot enroll in a Medigap plan, and vice versa.
Is a Medicare Supplement plan right for me?
For many people, the choice between Medicare Supplement and Medicare Advantage comes down to price, flexibility and how you prefer to pay for care.
Ask yourself:
- Do I want the stability of a higher monthly cost with little to no money spent out of pocket when I receive care?
- Can I afford to pay some costs out of pocket if they are less costly and more predictable than with Medicare Part B alone?
- Do I want flexibility to receive care from doctors who accept Medicare without staying in a plan network?
- Am I comfortable purchasing a stand-alone Part D prescription drug plan?
A Medicare Supplement plan might be a good fit if you:
- Don't mind paying a higher monthly premium, but paying less – or nothing – when you get medical care
- Live outside of Michigan for more than a month each year and want to seek routine health services when you're away
- Don't want to worry about staying in-network for your services to be covered, because Medigap plans don’t use networks
- Don’t mind having a stand-alone Part D prescription drug plan
Priority Health Medicare Supplement Plan options
There are 10 standard Medigap plans (named A through N), but not all insurance companies offer all plans. Priority Health offers Plans A, C, D, F, G and N.
Plan A covers the least, and Plan F covers the most. In addition to comparing monthly premiums, it’s important to look at what you’ll pay toward copayments, coinsurance and deductibles.
And remember, Medigap plans don’t include prescription drug coverage.