Alternatives to Medigap

Not everyone needs a Medicare supplement policy. If you have certain other types of health coverage, the gaps in your Medicare coverage may already be covered. You don’t need Medicare supplement insurance if

  • You have group health insurance through an employer or former employer, including government or military retiree plans.
  • You have Medicare Advantage plan coverage and want to keep it.
  • Medicaid or the Qualified Medicare Beneficiary (QMB) Program pays your Medicare premiums and other out-of-pocket costs. QMB is one of several Medicare Savings Programs that help pay premiums, deductibles, and coinsurance.
Employee Group Plans

If you remain employed after your 65th birthday, you may continue your group health insurance through your employer and may not need Medicare Part B until you retire. Likewise, if you have health coverage through a spouse’s plan, you may be able to delay enrollment in Medicare Part B. You can verify with Social Security if you can delay Medicare Part B enrollment. If you keep group insurance after retirement, you may not need a Medigap policy if your group plan covers the gaps in Medicare parts A and B.

Some employers offer their retirees coverage through a group Medicare supplement plan. Because health plans work differently, talk to your employer’s benefits coordinator before making a decision about Medicare Supplement insurance.

COBRA Coverage from an Employer Plan

Federal and state law allows employees who leave their jobs to continue their employer sponsored group health coverage for a certain amount of time. In some cases, you may also continue family coverage through your former employer. If you continue your employer sponsored coverage, you may not need a Medicare Supplement policy. Be advised that COBRA coverage impacts the time frames for enrolling in Medicare Part B without a penalty.

Additional information on employer coverage and COBRA is available at Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare, or by searching www.medicare.gov.

Medicare Advantage Plans

Depending on where you live, you may have the option to choose original Medicare or a Medicare Advantage plan. If you have a Medicare Advantage plan, you don’t need and can’t use a Medicare Supplement policy. Medicare Advantage plans vary in coverage, but they will at a minimum provide the same benefits as original Medicare. Many Medicare Advantage plans provide a lot more and may be a good option for you if you live in an area that has them.

If your Medicare Advantage plan terminates its contract in your service area, you have the right to purchase many of Medicare supplement plans (usually A, B, C, F, K, or L) without regard to your medical history or condition. If your Medicare Advantage plan ends services in your area, it must explain to you in writing your options and time frames to buy a Medicare Supplement policy. This right is limited to Plan A for people under age 65.