Who is eligible to purchase a Medigap policy?

An individual is eligible to purchase a Medigap policy if they are enrolled in Medicare Part A and Part B. Medigap, also known as Medicare Supplement Insurance, is designed to help cover some of the out-of-pocket costs that Medicare does not fully pay for, such as copayments, coinsurance, and deductibles.

To qualify for a Medigap policy, a person must first be enrolled in both parts of Medicare because Medigap plans are intended to supplement the benefits provided by Medicare, rather than to serve as a standalone insurance option. This requirement ensures that Medigap policies can effectively fill the gaps in coverage provided by Medicare.

In addition, the eligibility criteria exclude other groups, such as those under 65 who may have specific needs or conditions, and individuals relying on Medicare Part C (Medicare Advantage), as these plans typically incorporate supplemental coverage within their structure. Furthermore, Medigap policies are not designed for individuals who have health benefits through their employer because those benefits might already cover the same out-of-pocket costs that Medigap would address.