Senior Health Information and Insurance Education

Medicare Supplement (Medigap) Plans

How does it work?

Medicare Supplement (Medigap) Plans are sold by private insurance companies. A beneficiary will still be covered by Medicare and be able to work with providers that accept Medicare as an insurance. The plan will fill gaps that Original Medicare Parts A and B do not cover, like deductibles, copayments and coinsurance. The plans available to be sold at this time do not include prescription drug coverage.

The plans are standardized for easier shopping, all you have to decide is which Medigap Plan (A-N) meets your needs and compare premiums from the companies that sell them in South Dakota.

What will it cost?

  • Medigap requires a monthly premium. Premiums vary depending on your age, gender, smoking status and the coverage you choose.
  • SHIINE's Medicare Supplement Consumer's Guide explains Medigap plans and lists the companies that were willing to share their pricing information. All prices are based off of a example scenario and are estimates as of the date the guide was printed.

How do I compare plans?

  • Read through SHIINE's Medicare Supplement Consumer's Guide.
  • Call a few of the companies in that guide, your insurance agent, a company a friend or family member has recommended, and any Medicare Supplement Plans offered by your former employer.
    • The coverage will be the same if you are comparing the same plan (Lettered A-N).
  • The most popular plans sold in South Dakota are Plans F and G. Use the chart in the back of the guide to determine what each plan (A-N) covers to determine your preference.

How can I enroll?

  • You must be enrolled in Original Medicare Parts A and B, to qualify for Medicare Supplement (Medigap) plans.
  • You can enroll in Medicare Supplement plans by contacting the private insurance company directly.
Open Enrollment (Guaranteed Issue Right)
The best time to enroll in a Medicare Supplement (Medigap) plan is during your Open Enrollment (Guaranteed Issue Right). This is usually the first six months in which you are enrolled in Part B. This Open Enrollment is different than Part C or Part D.
    • If you enroll outside of this time frame the plan can decide if they want to enroll you or not based on your health history or enrollment capacity.
Outside of Open Enrollment (including changing plans)

If you apply for a Medicare Supplement Plan after your Open Enrollment (Guaranteed Issue Right) there is no guarantee that an insurance company will sell you a policy if you don't meet the medical underwriting requirements. Because of this, you must be cautious before switching your Medigap policy so you do not terminate your existing policy before you are officially enrolled in the new plan.

South Dakota has Medicare SELECT policies available and these policies may require you to use hospitals and, in some cases, doctors within its network to be eligible for full benefits. There may be additional enrollment opportunities with those plans.

Dropping your Medicare Supplement Policy

In most cases the plan cannot drop your coverage if you are paying the premium, they are considered a guaranteed renewable policy. For most people enrollment in a Medicare Supplement Plan is for the long term. If you want to terminate your coverage you must contact your insurance company to cancel it. Before doing so make sure you are satisfied in your new coverage and be cautious of gaps in coverage.


 
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