Medicare vs. Medicare Supplement Insurance: What’s the Difference?
Original Medicare and Medicare Supplement Insurance aren’t two versions of the same coverage. They serve different purposes and can work together to help manage healthcare costs. If you’re considering Medicare Supplement insurance in Georgia, understanding that distinction is an important first step before comparing available Medigap policies.
What Does Original Medicare Cover?
Original Medicare consists of Part A and Part B.
Part A generally helps cover inpatient hospital care, skilled nursing facility care, hospice care, and certain home health care. Part B generally covers medically necessary doctors’ services, outpatient care, preventive services, and certain medical equipment.
However, Original Medicare doesn’t pay for every covered healthcare expense in full. Depending on the service, you may have deductibles, coinsurance, and other out-of-pocket costs. Original Medicare also generally doesn’t include routine coverage for services such as most dental care, routine eye exams for glasses, or hearing aids.
Understanding these gaps is important when considering whether additional coverage makes sense for your circumstances.
What Is Medicare Supplement Insurance?
Medicare Supplement Insurance, commonly called Medigap, is private insurance designed to help pay some of the healthcare costs that Original Medicare doesn’t fully cover.
For example, depending on the specific Medigap plan, it may help pay certain:
- Part A coinsurance and hospital costs
- Part B coinsurance or copayments
- Blood costs
- Skilled nursing facility coinsurance
- Medicare-covered emergency care during certain foreign travel
The benefits depend on the plan you choose. Not every Medigap policy provides the same coverage, so it’s important to compare the available options rather than assuming all Medicare Supplement plans work identically.
How Do Medicare and Medigap Work Together?
Medigap doesn’t replace Original Medicare. You generally need to have Medicare Part A and Part B to purchase a Medigap policy.
When you receive a Medicare-covered service, Original Medicare generally pays its share first. Your Medigap policy may then help pay certain remaining costs according to the policy’s terms.
This arrangement can make healthcare expenses more predictable for some people, but Medigap policies generally don’t cover everything. For example, they don’t typically cover long-term care, private-duty nursing, or prescription drugs.
If prescription drug coverage is important to you, you may need to consider a separate Medicare Part D plan.
What Should You Consider Before Choosing Medigap?
Your healthcare needs and budget should both factor into the decision. Consider how frequently you visit healthcare providers, whether you travel, how comfortable you are with potential out-of-pocket costs, and which benefits are important to you.
You should also compare premiums and understand that premiums can vary by plan, location, pricing method, age, and other factors. If you’re comparing Medigap plans in Georgia, make sure you’re reviewing policies available to you rather than relying on general pricing information.
Your enrollment timing also matters. The Medigap Open Enrollment Period begins when you’re 65 or older and enrolled in Part B. During this period, you generally have broader protections when purchasing a Medigap policy.
Compare Your Available Options
Choosing between Original Medicare alone and Original Medicare with Medigap isn’t simply a matter of finding the lowest premium. It’s about understanding how your coverage would work and what healthcare costs you may still be responsible for.
Value Financial Protection helps Georgia residents review available Medicare and Medicare Supplement options based on their healthcare needs, budget, and circumstances. A licensed Medicare advisor can explain plan differences, coverage considerations, and enrollment factors so you can better understand the choices available to you.
If you’re considering Medicare Supplement insurance in Georgia, contact our Medicare consultants to schedule a meeting and review the Medigap options available in your area.
DISCLAIMER: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or call 1-800-MEDICARE to get information on all your options.