If I’m covered by Medicare, should I have additional health insurance?

If I’m covered by Medicare, should I have additional health insurance?


It’s often wise to purchase health insurance to supplement your Original Medicare coverage, because Medicare generally won’t cover all of your medical expenses. Usually, you’ll have to satisfy a deductible before Medicare pays anything, and you’ll also pay a co-payment when you visit a physician or are admitted to the hospital.

Fortunately, you can buy supplemental insurance from private companies that will help you plug the gaps in your Medicare coverage. These Medigap plans are regulated and standardized by the federal government. There are 10 different kinds of plans, although your state may not offer all of them (and three states, Massachusetts, Minnesota, and Wisconsin, have their own standardized plans). If premium cost is a concern, you can purchase lower-cost Medigap plans that only partially cover Medicare deductibles, co-payments and coinsurance costs. Conversely, if you want extensive coverage and don’t mind paying more for it, you can purchase a Medigap plan that covers most of the deductibles, co-payments, and extra charges associated with Medicare. You can compare plans at the Health Care Financing Administration’s website (www.medicare.gov).

Whatever plan you choose, you have the right to cancel it within a certain amount of time (usually 30 days, sometimes longer) if you don’t like the policy after you buy it. In addition, the policy must be guaranteed renewable and cannot duplicate existing coverage, including Medicare.

Another way to supplement Medicare is to keep in effect any employer-sponsored health-care insurance you have. Depending on the type of coverage you have, and whether you’re retired, one plan will pay your health-care costs first, and the other plan will cover some or all of the remaining costs. To make sure claims are properly paid, let your health provider know when you have health insurance in addition to Medicare.

Note that if you have a Medicare Advantage (Part C) plan, you don’t need a Medigap plan, and it’s illegal for anyone to sell you one unless you’re in the process of switching back to Original Medicare.