AHIP Medicare Supplement (Medigap) Plans 1 — Questions and Answers
Question 1: What is the primary purpose of Medicare Supplement (Medigap) insurance?
- To replace Original Medicare with private coverage
- To pay for costs not covered by Original Medicare, such as copayments and deductibles (Correct answer)
- To provide standalone prescription drug coverage
- To cover long-term care and custodial services
Correct answer: To pay for costs not covered by Original Medicare, such as copayments and deductibles
Medigap policies help pay for 'gaps' in Original Medicare coverage, such as copayments, coinsurance, and deductibles, but do not replace Medicare.
Question 2: When does the 6-month Medigap Open Enrollment Period begin for a beneficiary who is 65 or older?
- The month the beneficiary turns 65
- The month the beneficiary enrolls in Medicare Part B and is 65 or older (Correct answer)
- January 1 of the year the beneficiary turns 65
- The month the beneficiary first enrolls in Medicare Part A
Correct answer: The month the beneficiary enrolls in Medicare Part B and is 65 or older
The Medigap Open Enrollment Period begins the first month a beneficiary is both enrolled in Medicare Part B and aged 65 or older, lasting 6 months.
Question 3: How many standardized Medigap plan types are available to most Medicare beneficiaries in the United States?
- 8
- 10 (Correct answer)
- 12
- 15
Correct answer: 10
There are 10 standardized Medigap plans (A, B, C, D, F, G, K, L, M, N) available in most states, each offering a defined set of benefits.
Question 4: Which of the following is TRUE about Medigap policies?
- They can be used simultaneously with a Medicare Advantage plan
- Each policy covers only one person — spouses each need their own policy (Correct answer)
- They automatically include Medicare Part D prescription drug coverage
- They are sold and administered directly by the federal government
Correct answer: Each policy covers only one person — spouses each need their own policy
Medigap policies are individual policies — each insured person needs their own plan; coverage does not extend to a spouse.
Question 5: Which Medigap plans are NO LONGER available to beneficiaries who first became eligible for Medicare on or after January 1, 2020?
- Plan G and Plan N
- Plan C and Plan F (Correct answer)
- Plan A and Plan B
- Plan K and Plan L
Correct answer: Plan C and Plan F
Plans C and F are unavailable to newly eligible beneficiaries because they cover the Medicare Part B deductible, which was prohibited for new enrollees under MACRA.
Question 6: Medigap Plan G covers all of the following EXCEPT:
- Medicare Part A coinsurance and hospital costs
- Medicare Part B coinsurance or copayment
- The Medicare Part B deductible (Correct answer)
- Foreign travel emergency care up to plan limits
Correct answer: The Medicare Part B deductible
Plan G covers nearly all Medicare cost-sharing gaps except the Medicare Part B deductible, which is the sole difference from the now-restricted Plan F.
Question 7: What is the key difference between a Medigap policy and a Medicare Advantage plan?
- Medicare Advantage is offered by private insurers; Medigap is administered by the federal government
- Medigap works alongside Original Medicare; Medicare Advantage replaces Original Medicare (Correct answer)
- Medigap covers prescription drugs; Medicare Advantage does not
- Medicare Advantage is only available to beneficiaries over age 70
Correct answer: Medigap works alongside Original Medicare; Medicare Advantage replaces Original Medicare
Medigap supplements Original Medicare by filling in cost-sharing gaps, while Medicare Advantage is a private plan that replaces Original Medicare entirely.
AHIP Medicare Supplement (Medigap) Plans 1
What is the primary purpose of Medicare Supplement (Medigap) insurance?