Frequently Asked Questions About Medigap Plans
Can I switch from Medicare Advantage to a Medigap plan?
You can return to Original Medicare during the annual Medicare Advantage Open Enrollment Period from January 1 through March 31. However, purchasing a Medigap policy at that time generally requires medical underwriting unless you qualify for a federal trial right.
If you joined a Medicare Advantage plan when you first became eligible for Medicare at 65, you retain a 12-month trial right to return to Original Medicare and buy a Medigap plan with guaranteed issue protections.
Does Medigap cover prescription drugs, dental, or vision care?
Standard Medigap policies do not cover outpatient prescription drugs, routine dental exams, dentures, eyeglasses, or hearing aids. Federal law prohibited new Medigap plans from including prescription drug coverage after 2006.
To obtain prescription drug coverage, you must enroll in a standalone Medicare Part D drug plan. You must purchase separate private policies or discount programs for routine dental and vision services.
What happens if my doctor does not accept Medicare assignment?
Providers who do not accept assignment can bill up to 15 percent above Medicare-approved amounts as Part B excess charges. If you hold Plan G or Plan F, your supplement policy covers these excess charges entirely.
If you hold Plan N or Plan A, you must pay excess charges out of pocket. You can avoid excess charges altogether by confirming that your physicians accept Medicare assignment before scheduling appointments.
Are Medigap benefits the same regardless of which company I choose?
Yes, federal law requires insurance companies to offer standardized benefits for each plan letter. A Plan G sold by one insurer pays the exact same medical claims as a Plan G sold by another insurer.
Because benefits do not vary, you should focus on monthly premium costs, premium pricing structures, and insurer customer service reputation when making your decision.
HealthyHabits.care is an independent publication and is not connected with or endorsed by the U.S. government or the federal Medicare program. This article is general information, not insurance or legal advice. For free, unbiased help with your coverage, contact your State Health Insurance Assistance Program (SHIP) or call 1-800-MEDICARE.
