3 Reasons You Might Benefit From a Medigap Plan

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Kimberly Harris Insurance Agent

For more information about the author, click to view their website: Kimberly Harris Insurance Agent

Posted on

May 20, 2025

Seniors enrolled in Medicare Parts A and B might not know that there are additional forms of coverage available to fill the gaps left by Original Medicare. These types of plans are called Medicare Supplement Insurance, or Medigap plans.

Medigap plans are private insurance plans that help cover the out-of-pocket costs for Original Medicare by serving as a secondary form of insurance. You’ll pay a monthly premium for this plan as long as you have it. There are 10 federally regulated Medigap plan types, each of which cover slightly different things.

Although Medigap plans may benefit a great number of seniors on Medicare, many people pass over them because they don’t think they need one.

Here are three of the top reasons you might benefit from enrolling in a Medigap plan.

1. You want to minimize your out-of-pocket healthcare costs

The most common reason seniors enroll in a Medigap plan is to minimize their potential out-of-pocket costs for healthcare. Under Original Medicare, you are usually required to pay deductibles, copayments and coinsurance when you seek treatment, on top of your monthly Part B premium. For outpatient services alone, you’ll pay 20 percent after you meet the deducible. These costs can add up significantly over time, especially because there is no out-of-pocket maximum for Parts A and B!

Medigap plans cover some of these costs for you. The exact amount covered will depend on the type of Medigap plan you select, but most plans cover some or all of the coinsurance and copayments owed after Medicare pays its share.

Enrolling in a Medigap plan also allows you to budget for healthcare more carefully. With only Original Medicare, your healthcare costs might vary dramatically based on how often you receive healthcare services. These fluctuating costs can be challenging for seniors who live on a fixed income. With a Medigap plan, you’ll pay a standard monthly premium, but the plan will pay for many of your out-of-pocket costs, allowing you to standardize your payments from month to month.

2. You have preexisting health conditions

Seniors with preexisting health conditions know that they will have recurring healthcare needs after they enroll in Medicare. This means that your out-of-pocket healthcare costs will likely be higher than the average healthy senior’s.

Fortunately, seniors enrolling in Medicare for the first time are given a special, one-time enrollment period for Medigap plans. During this period, private insurance companies are not allowed to ask health questions to determine your eligibility or premiums. This means you are able to purchase a Medigap plan with guaranteed coverage, regardless of any preexisting conditions. If you do this, you’ll benefit from the cost coverage the plan provides for as long as you hold it.

3. You want emergency health insurance overseas

One unique benefit of some Medigap plans is foreign travel emergency healthcare coverage. Original Medicare by itself may not cover healthcare services overseas. Should you get sick or injured on your trip, your Medigap plan will cover some of those costs for you.

If you plan to travel internationally during retirement (as many seniors do), you may benefit from this type of Medigap plan.

Are you interested in learning more about Medigap plans and the coverage they provide? PlanEnroll is ready to help! We represent a range of Medicare plans that can help you access the specific benefits and coverage you need.

PlanEnroll is a brand operated by Integrity Marketing Group, LLC and used by its affiliated licensed insurance agencies that are certified to sell Medicare products. PlanEnroll is not endorsed by the Center for Medicare & Medicaid Services (CMS), the Department of Health and Human Services (DHHS), or any other government agency.

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legal, tax, estate planning, or other licensed professionals should also be involved.What to Gather Before Applying for HCBS MedicaidFamilies can make the process easier by preparing early.Useful information may include:Proof of identitySocial Security incomePension incomeBank statementsInvestment accountsProperty informationInsurance policiesHousehold expensesTrust or annuity recordsPrior financial transfersCurrent diagnosesFunctional limitationsExisting care servicesIdaho specifically identifies household income, resources, monthly expenses, and identity information among the materials applicants should be prepared to provide.Frequently Asked Questions About Idaho Medicaid HCBSCan Idaho Medicaid pay for care at home?Potentially. Idaho offers Home and Community-Based Services that may provide qualifying people with personal care, homemaker services, respite, case management, adult day health, and other community supports.What are the 2026 Idaho HCBS financial limits?Idaho currently publishes a $3,002 monthly individual income limit and $2,000 individual resource limit for HCBS in 2026, subject to all additional Medicaid eligibility rules.Does someone have to need nursing home-level care to qualify?Idaho requires a Level of Care Determination for HCBS applicants. The assessment evaluates whether the person needs the type of care associated with an institutional long-term care setting.Can Medicaid help someone move out of a nursing home?For certain qualifying members, Idaho Home Choice can help transition someone from an institutional setting into a home or community residence.Does receiving Medicaid care at home affect estate recovery?Potentially. Idaho states that estate recovery can apply to certain Medicaid-funded community-based in-home care services for qualifying recipients.Long-Term Care Planning Should Include More Than One SettingFamilies sometimes feel that long-term care decisions offer only two choices:Pay privately at home.Or move into a nursing facility.Idaho Medicaid's Home and Community-Based Services show that the picture can be more flexible.For qualifying individuals, support may be available through personal care, homemaker assistance, respite, transportation, adult day services, home-delivered meals, accessibility modifications, case management, and other community-based services.The challenge is understanding how financial eligibility, functional eligibility, Medicaid rules, and the person's actual care needs fit together.For families in Nampa and Canyon County, Idaho Medicaid Planning on SeniorsBlueBook.com provides a local resource focused on navigating that process and helping families understand potential paths toward qualification.The right question is not always:Which nursing home can Medicaid pay for?Sometimes it is:What level of care does this person need, and is there a safe Medicaid-supported way to provide it in the community?Understanding that distinction can give families more options and more time to make thoughtful long-term care decisions.This article provides general educational information and is not legal, tax, financial, or Medicaid eligibility advice. Program rules, limits, service availability, and individual eligibility can change. Families should verify current information with the Idaho Department of Health and Welfare and consult appropriate qualified professionals for individualized guidance.

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