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Bookmark These Questions to Ask Your Medigap Agent

You’ve spent weeks, if not months, shopping around for the perfect Medicare plan. Now that you’re ready to enroll, you probably have many questions or simply don’t know what to ask.

No worries! I’m here to help, so grab a pen and notepad! I’ve put together a list of questions you should ask your Medicare agent before you enroll.

What Are the Most Popular Medigap Plans in My Area?

The same Medigap plans are available in most states (with the exception of Massachusetts, Minnesota, and Wisconsin). The most popular Medigap plans are Plan F, Plan G, and Plan N.

One of the factors that impact your Medigap premiums is your location. Ask your agent what pricing method each carrier uses in your state to determine which letter plan is best for you.

Will My Medigap Coverage Cover Me Outside the United States?

Unlike Medicare Advantage, your Medigap coverage will travel with you across all 50 states. If you plan on traveling outside the United States, ask your agent about foreign travel coverage options. Some Medigap plans will cover you outside the United States, but only up to plan limits.

Can You Provide a List of Similar Medigap Plans with Lower Premiums?

Since Medigap plans are standardized across the United States, the benefits will remain exactly the same from carrier to carrier. If you choose Plan G, the benefits will be the same regardless of what carrier you choose to enroll with. The only difference is the monthly premium.

However, having the lowest premium is not always the best option. Make sure to not only ask your agent to compare premiums, but also rate increases and company ratings.

Is There a Waiting Period Before a Medigap Policy Covers My Pre-Existing Conditions?

This depends on when you’re enrolling. If you enroll during your Medigap Open Enrollment Period, you don’t have to medically qualify. You’re not subject to questions about your health or medications. If you’re enrolling outside your Medigap Open Enrollment Period, there could be up to a 6-month waiting period depending on your pre-existing condition.

If you have a pre-existing condition, ask your agent which carriers are more lenient on waiting periods in your state.

When Will My Medigap Coverage Go into Effect?

If you’re proactive and enroll before your Part B becomes active, your Medigap plan will go into effect the same day as your Part B. If you’re losing group coverage, your Medigap plan will go into effect right after your group coverage ends. If your Part B is already in effect and you have no group coverage, your policy could become effective immediately.

Make sure to ask your agent what your effective date is to avoid any lapse in coverage.

What Are My Out-Of-Pocket Costs with Medigap?

This depends on the letter plan you choose. Each letter plan covers the core policy benefits found in Plan A. If you’re eligible for Plan F, this letter plan will leave you with zero out-of-pocket costs. The only cost-sharing under Plan G is the Part B deductible. With Plan N, there are small co-pays.

Ask your agent what the cost-sharing is for the letter plan of your choice, so you are prepared for any out-of-pocket costs.

Questions to Ask Your Medicare Agent About Part D

Medicare Part D helps pay for prescription drugs. It’s recommended to apply when you’re first eligible to avoid paying a late penalty fee. When you enroll in a Medigap plan, you’ll want to also enroll in a stand-alone Part D plan. Medigap plans do not cover prescription medications you pick up at your pharmacy.

These are just a few of many questions you need to have ready for your Medicare agent.

Are My Medications Covered?

Each Part D plan has its own formulary. Make sure to let your agent know what medications you’re currently taking so they can make sure all of them will be covered.

Can I Choose a Pharmacy of Choice?

Carriers partner with a chain of pharmacies to offer you the lowest prices in the market. When speaking to an agent, ask the name of the preferred pharmacy for the plan you’re considering.

Do I Have the Option of Receiving My Prescriptions in the Mail?

Not all Part D providers offer mail-order prescriptions. But if you prefer to have your medications delivered to your door, let your agent know so they can filter your options accordingly.

What’s one Medicare question you regret never asking that still haunts you today? What are three things someone should consider before enrolling in Medicare? What are some Medicare questions you found helpful that aren’t listed in the article? Please use the comment box below.

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The Author

Lindsay Malzone is the Medicare expert for Medigap.com. She has been working in the Medicare space since 2017. Lindsay has a passion for sharing her expertise on Medicare to beneficiaries so they can be better prepared for healthcare costs after retirement. Her YouTube channel features various videos that help Medicare beneficiaries discover all their options.

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