ABA Family Legal Guide

The Rights of Older Americans

Health and Long-Term Care Benefits

Medigap Insurance

Who doesn't need a Medigap policy?

While most people need Medigap coverage, you may already have enough coverage without it if you meet one of these four conditions:

1. If you are already covered by Medicaid, you do not need a Medigap policy. Medicaid covers the gaps in Medicare and more.

2. If you are eligible for help under the Medicare Savings Program. This program pays some or all of Medicare's premiums and may also pay Medicare deductibles and coinsurance for certain people who are not eligible for Medicaid but nevertheless have a limited income and assets.

3. If you have retiree health coverage through a former employer or union, you may not need Medigap insurance. This coverage may be comprehensive, or alternatively, be expressly designed to coordinate its coverage with Medicare. Examine the coverage, costs, and stability of your coverage to determine whether it is a better option than Medigap.

4. If you belong to a Medicare Advantage Plan, you probably do not need a Medigap policy, since coverage is normally comprehensive. But do not give up your Medigap coverage too quickly if you are joining a Medicare Advantage Plan. If you can afford it, keep it long enough to be sure you are satisfied with the managed care organization.