Medicare Supplement Insurance

Medicare, the federal health insurance program, alone does not cover all of your medical expenses. With all the deductibles and co-payments, you could end up having out-of-pocket expenses. A Medicare supplement insurance plan can help you cover these costs.

When you become eligible for Medicare, it may be the primary means of paying for your medical expenses for the rest of your life. The more you understand about the benefits, the better prepared you and your family will be.

What is Medicare supplement insurance?

Medicare provides benefits for the most acute medical needs. However, it can still leave you with out-of-pocket expenses. Those expenses could be substantial if you experience a catastrophic illness or repeated hospitalization.

Because of deductibles, coinsurance and medical expenses not covered by Medicare, most people may need supplemental health insurance to help pay for these expenses.

Medicare supplement insurance helps pay expenses not covered by Medicare, such as deductibles and coinsurance. However, non-covered charges will be the insured's responsibility. Policies that meet the definition of Medicare supplement insurance are clearly labeled, usually on the policy's front cover.

Federal regulations for Medicare supplement insurance

Federal law in all but three states requires companies to standardize Medicare supplement insurance policies. Standardized plans must follow the model set of standard plans: A, B, C, D, F, F (high deductible), G, K, L, M and N. Plan A, a core benefit package, is available from all Medicare supplement insurers. Plans offered by companies must be the standardized models.

Massachusetts, Minnesota and Wisconsin require companies to sell benefit plans as defined by their state laws.

The following provisions apply to all states:

  • 30-day free look – As a customer, you have 30 days from the date you receive a policy to review it. If you decline the policy within this period, the company must refund all the premium you paid.
  • Open-enrollment period – The best time to buy a Medicare supplement insurance policy is during your open enrollment period. The open enrollment period lasts six months and begins on the first day of the month in which you are both:
    • Age 65 or over and enrolled in Medicare Part B;1 or
    • Under age 65, with a disability or end-stage renal disease (except in CA) and enrolled in Medicare Part B. This applies to select states. Please refer to the current "Guide to Health Insurance For People With Medicare" at (Link opens in new window).
    During this six-month open-enrollment period, an insurance company cannot deny you Medicare supplement insurance coverage or increase the premium for a policy because of past or present health problems.

Understanding Medicare supplement insurance and the benefits provided in the standardized plans can help you select the plan that best meets your needs.