Medicare covers a wide range of health care needs for people aged 65 and over. Part B is for hospital services, such as surgeries and major medical procedures. Part D covers outpatient prescription drugs and other health care services. The two policies work together to provide comprehensive coverage for Medicare beneficiaries.
In this article, we will explore how Medigap coverage works with Medicare Parts B and D. We will also answer some common questions about Medigap coverage, like what is covered and what is not covered.
Both Medicare Parts B and D cover health care costs
Medigap coverage works with Medicare Part B, which is an insurance program that helps pay for doctor visits, outpatient care, and some hospital stays.
Medigap coverage also works with Medicare Part D, which is a prescription drug coverage program.
Both Medicare Parts B and D have rules about what counts as a covered expense. For example, you can’t use Medigap coverage to cover expenses for food or shelter. However, Medigap coverage can help cover costs for things like doctor visits and outpatient care.
There are important differences between the two types of Medicare insurance. For example, Medigap coverage doesn’t cover most hospital stays, but it does help pay for doctor visits and outpatient care. Medicare Part D covers most prescription drugs, but it doesn’t help pay for doctor visits or outpatient care.
If you’re interested in learning more about Medigap coverage and Medicare Part B or Part D, you can visit the Centers for Medicare & Medicaid Services website or call toll-free 1-800-MEDICARE (1-800-633-4227).
A Medigap policy covers some of the costs not covered by Medicare Parts B and D
Medigap policies offer a variety of coverage options, including by plan type (Hospital and Medical Plans, Dental Plans, and Vision Plans), by state, and by provider.
Most Medigap policies have a monthly premium and a copayment for each service visit. However, some plans have lower premiums with no copays for covered services.
The table below shows the average monthly premium and the out-of-pocket cost for select Medigap policies.
Average Monthly Premium
Hospital Medical Plan $36.68 $8.33 $174.07 Hospital Medical Plan with No Copays $0 $0 $0 Dental Plan $24.93 $4.59 $111.44 Dental Plan with No Copays $0 $0 $0 Vision Plan $21.68 $3.99 $102.33 Vision Plan with No Copays** $0 $0 $0
*Out-of-pocket costs are after insurance coverage is applied
**Vision Plan only covers eye exams
Medigap coverage is dependent on the plan you have
If you have Medicare Part A, your Medigap coverage will cover some of the costs for doctor’s services and prescription drugs.
If you have Medicare Part B, your Medigap coverage will help pay for out-of-pocket expenses like doctor’s services, outpatient care and prescription drugs.
If you have Medicare Part D, your Medigap coverage will help pay for prescription drugs only.
To find out if you qualify for a Medigap policy and what benefits it provides, visit the Medicare website or speak with your healthcare provider. You can also compare plans online.
Your Medicare card will include information about Medigap coverage
Medigap plans are insurance plans that supplement Medicare coverage. You can choose between two types of Medigap plans: traditional or catastrophic.
Traditional Medigap coverage helps you pay for out-of-pocket costs like doctor visits, hospitalizations, and prescription drugs. Catastrophic Medigap coverage pays for bills that would cause you to go over your Medicare deductible or limit on in-patient hospital days.
You can apply for Medigap coverage online or through the mail. You may also be able to get help from a Medicare advisor if you have questions about how to apply for Medigap coverage.
enrolled in Medicare Parts B or D,
you may be covered for medigap policies.
Medicare Part B coverage is based on your enrollment in the program. If you are not enrolled, your coverage is based on your income.
Medicare Part D coverage is also based on your enrollment in the program. However, if you are not enrolled, your coverage is based on your income and the cost of the policies you select.
If you have questions about how medigap coverage works with Medicare Parts B and D, please call the Centers for Medicare & Medicaid Services at 1-800-MEDICARE (1-800-633-4227).