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Are You Eligible for Supplemental Insurance (Medigap)?
Medicare supplemental insurance, also called Medigap, is a health insurance policy that helps fill the coverage "gaps" in Original Medicare. Because Medigap policies supplement your Medicare coverage, you must be enrolled in Medicare Part A and Medicare Part B to be eligible for this type of policy.
Am I eligible if I'm under age 65?
If you are under 65 and have Original Medicare due to a disability or End-Stage Renal Disease (ESRD, you may be eligible for a Medigap policy. However, depending on where you live, you might not be able to purchase the policy option you want—or any Medigap policy—until you turn 65. That's because Federal law does not require insurance companies to sell Medigap policies to people under 65.
Currently, only 29 states require insurers to sell policies to people who are eligible for Medicare and under the age of 65:
*Medigap policies are not available to people with ESRD in these states.
**Medigap policies are available only to people with ESRD in these states.
Even if your state is not listed above, some insurance companies will sell Medigap policies to people under 65. These companies may charge more for the policy or deny coverage for preexisting conditions, so you should review your rights under state law before making a purchase. You can get this information by calling your State Health Insurance Assistance Program.
Am I eligible if I have a Medicare Advantage Plan?
In general, you are not eligible for a Medigap policy if you have a Medicare Advantage Plan, also called Medicare Part C. However, you may be able to buy a Medigap policy under certain situations, such as if you are eligible for "trial rights."
Trial rights allow you to join a Medicare Advantage Plan for a trial period when you first turn 65 and become eligible for Medicare. If you are not happy with the plan any time within the first 12 months, you can return to Original Medicare. Before returning to Original Medicare, you can apply for any Medigap policy that is sold in your state. Your new policy should go into effect the same time your Medicare Advantage Plan enrollment ends, so there are no breaks in your coverage.
You also have the right to buy certain Medigap polices if:
- You leave a Medicare Advantage Plan because the company has broken rules or misled you
- Your Medicare Advantage Plan leaves Medicare or stops providing services in your area
- You move out of the plan's service area
Under these circumstances, you are eligible to buy any Medigap Plan A, B, C, F, K, or L that is sold in your state. Remember, you still must return to Original Medicare in order to get a Medigap policy.
Important note: It is illegal for anyone to sell you a Medigap policy if they know you are in a Medicare Advantage Plan, unless your coverage in this plan will end before the Medigap policy goes into effect.
For additional information on trial rights and other rights you have when buying a Medigap policy, click here.
Am I eligible if I have coverage through Medicaid?
If you receive Medicaid, you do not need supplemental coverage. In fact, it is generally illegal for insurance companies to sell Medicaid policies to anyone who is receiving Medicaid.