Does My Supplemental Insurance Cover What Medicare Does Not?



Supplemental insurance plans fill in the gaps between what Medicare pays and the out-of-pocket costs (copay, deductible, and co-insurance) that the insured is responsible for. What the supplemental insurance pays is based soley on the plan chosen and what Medicare accepts for services rendered. Medicare adds and removes services yearly so it is important to keep up on changes on a regular basis.

What Do Supplemental Plans Cover

Supplemental insurance, also called Medigap, will pay some of what Medicare does not pay. However, the plan in most cases, only pays for things that Medicare has deemed are “medically necessary” and based on Medicare approved charges. Plans range from paying a small percentage to the full amount of what Medicare pays depending on the plan chosen.

Where Can I Get It

Supplemental insurance is sold by individual private insurance companies that are required to follow federal and state laws, but are not run by Medicare. Supplemental insurance plans are usually designated by a letter (A, B, C, etc.) indicating what type of coverage is included in a particular plan. The more coverage you have, the more expensive the premiums, the more letter designations the plan will have. It is important to know that supplemental insurance does not cover prescription drugs, this is a separate policy.

When looking at supplemental insurance plans that cover some or all of what Medicare does not, it is important to look at individual needs and overall health, taking into account the present and future. Supplemental plans can sometimes be expensive so it is also important to determine what type of premium one can afford in the longterm. The bottom line is that in most cases supplemental insurance does cover what Medicare does not.



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