Questions & answers · Health insurance
Medicare refused a service. Will my Medigap policy pay it instead?
Health insuranceDeniedChecked Nov 6, 2026
From K.Actuary, founded by Sangmin Kwon, ASA · sources checked 2026-11-06 · Source: Medicare.gov View original ↗
In short
- Medicare pays first. Then Medigap pays your share.
- If Medicare paid nothing, ask the Medigap insurer in writing how it handled it.
- Compare both statements for the same date.
What this means
Medicare.gov describes the order of payment. When you have a Medigap policy and get care, Medicare pays its share of the Medicare-approved amount for covered costs. Then your Medigap policy pays your doctor the amount you owe under your policy. You pay any costs that are left [1].
That is the page's description of how the two work together. The page does not say what Medigap does with a service Medicare refused to cover. So this answer stops at the order of payment.
Your next step
Check your own Medigap policy for how it treats a service that Medicare did not cover. The page describes only the order of payment [1]. The sources give no deadline.
Check it yourself
Open Medicare.gov, Learn how Medigap works, at https://www.medicare.gov/health-drug-plans/medigap/basics/how-medigap-works and read the part quoted above. Your own plan or policy papers hold details these sources do not give: "Don't know yet" for your case.
Where this comes from (1)
[1] Medicare.gov · checked 2026-11-06
If you have a Medigap policy and get care, Medicare will pay its share of the Medicare-approved amount for covered health care costs. In most Medigap policies, you agree to have the Medigap insurance company get your Part B claim information directly from Medicare. Then, your Medigap policy will pay your doctor whatever amount you owe under your policy and you're responsible for any costs that are left
How we found this
We matched your question to 1 official source, quoted the exact lines, and re-checked each quote against its source on 2026-11-06.
What we don’t know yet
Your own plan or notice may say something different. If your letter cites another rule, send it and we will look again.
Every answer is checked against the official rule it quotes.
Information only — not legal advice. Your plan, insurer or agency decides.
This answer quotes the official sources listed above, with the date we checked them. Your own policy, notice and state rules control. We are not your lawyer or your insurer. We don’t file, argue or negotiate claims for you — you send any letter or form yourself.
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Answer id CQ4309. Spotted an error? Tell us.