As you approach the age of 65, you become one of the most popular people in the world. You receive mail from every insurance carrier and company overnight, and then the phone calls start. There is genuinely a lot of information that you need to learn and understand. Below we’ll discuss what Medigap coverage is used for.
What is Medigap coverage used for?
Medigap is another name for Medicare Supplement plans. These plans help cover your coinsurance, deductibles, copayments, or any other out-of-pocket costs associated with Original Medicare. They are administered by private insurance companies such as Mutual of Omaha, Aetna, and United American.
The federal government standardizes Medicare Supplement plans. Standardization means that, for the most part, the coverage must be the same regardless of where you are or which carrier you choose.
There are a few states that have exceptions to standardization. Those states include Minnesota, Wisconsin, and Massachusetts.
About Medicare Supplement coverage
As mentioned above, Medigap coverage assists with your Medicare costs. There are 10 Medicare Supplement insurance plans from which to choose. Each program has varying levels of coverage.
Since these plans are supplemental coverage to Medicare, you must continue to pay your Medicare Part B premium in addition to any Medigap insurance you choose.
These plans will cover anything that traditional Medicare covers. Some will even provide you with emergency coverage for foreign travel.
Essentially they’ll cover all benefits and services that Medicare covers. We have listed some of those services below.
- Inpatient Hospital
- Skilled Nursing Facility
- Hospice care
- Outpatient services and procedures
- Doctor and specialist appointments
- Drugs administered in the Hospital, or Doctor’s office
What isn’t covered by Medicare Supplement plans?
Since Medicare insurance policies are secondary to Medicare, they only cover what Medicare covers. Medicare coverage is defined as medically necessary health care services.
Items that aren’t covered by Medicare supplements include:
- Dental care
- Vision care
- routine eye exams
- glasses
- Hearing care
- exams
- Hearing aids
- Long-Term care
- Prescription drugs picked up from the pharmacy – Medicare Part D
Costs covered by Medicare Supplemental insurance
Medicare Supplements cover some or all of your costs after Medicare pays.
Depending on the health coverage you choose, they could pay all or part of the following costs.
- Medicare Part A deductible – $1,632
- Per occurrence deductible each time, you’re admitted into the Hospital
- Medicare Part A Coinsurance
- Medicare Part A Copayment
- Daily copays begin
- After you’ve spent 60 days in the Hospital
- After you’ve spent 20 days in a skilled nursing facility
- Daily copays begin
- Medicare Part B deductible – $240
- Annual deductible
- Medicare Part B coinsurance
- 20% of the Medicare-approved amount
- Medicare Part B Excess charges
- Up to 15% above the Medicare-approved amount
Enrollment requirements for a Medigap policy
Medicare beneficiaries can enroll in a Medicare Supplement anytime, as long as they can pass medical underwriting.
A few cases allow you to enroll in a Medigap health insurance plan without underwriting. When you first turn 65, you’ll be in your Open Enrollment Period.
The Open Enrollment Period runs for six months. During this time, beneficiaries can enroll in any Medigap plan without underwriting.
Some states, such as New York and Connecticut, have special rules allowing you to enroll year-round or at certain times without underwriting.
There is also something called Guarantee Issue rights. Seven special situations allow you to enroll in specific Medigap plans without underwriting. Most of these revolve around losing creditable coverage at no fault of your own.
Medicare Supplement plan letter coverages
As mentioned above, they’re ten plan options to choose from. Most Beneficiaries select one of the top three plans. The most popular plans are Plans F, G, and N.
Plan F is the most comprehensive plan available. Essentially you pay your monthly premium, and Plan F pays your Medicare health care costs.
Plan G is the most popular plan when it comes to beneficiaries that are new to Medicare. This health plan offers almost the same coverage as Plan F. The only difference is it doesn’t cover the Medicare Part B deductible.
Plan N is a very popular plan for healthy and cost-conscious individuals. This plan offers an outstanding balance of monthly premiums versus good benefits. The main difference between Plans N and G is that Plan N has copays for doctor visits and the emergency room.
Below is a breakdown of all the available plans and what they cover. Plan F and Plan G both have high-deductible options as well.
What impacts the cost of Medigap Plans
With Medicare Supplement benefits being standardized, you need to consider are few things as you settle on your preferred plan—the monthly premium and the quality of the company.
Since the benefits are, the same monthly premium is one of the first things we consider. After all, who wants to pay more for the same thing?
There are a few factors that can affect your premium. Two of the significant contributors are your age and if you have any underlying health problems.
The quality of the company is essential. If you have an issue, would you prefer a company with excellent customer service or one where you struggle to speak to someone who can help?
A higher-quality company is also less likely to have high rate increases when compared to an as strong company.
What’s the difference between Medigap and Medicare Advantage?
You can enhance Original Medicare by adding secondary coverage with Medicare Supplement plans. A Medicare Advantage Plan is an insurance that takes over your Medicare benefits from the Medicare program. Private companies like Humana and UnitedHealthcare offer them.
These plans are required to cover the same benefits as traditional Medicare. In many cases provide extra benefits that Original Medicare doesn’t cover. They’ll usually include your Part D prescription drug coverage as well.
Medigap plans usually have higher premiums than those of Medicare Advantage. Medicare Advantage is another name for Medicare Part C.
FAQs
Is Medigap the same as supplemental?
Yes! A Medicare Supplement and Medigap plan are two names for the same coverage.
What does Medigap cover, and who provides it?
Medigap plans help fill the gaps in Medicare coverage. These plans cover part or all of your out-of-pocket costs after Medicare pays its portion. They are provided by private companies such as Mutual Of Omaha, Cigna, and Aetna.
What is the difference between Medicare and Medigap?
Medicare is your standard health insurance. Medicare Supplement picks up some of the costs left over by Medicare.
What are some of the advantages of Medigap?
Since you supplement your Medicare, you retain the right to choose any doctor nationwide that accepts Medicare. They travel with you, and the coverage will always be the same.
What healthcare services are not covered by Medigap?
Medicare Supplements don’t cover dental, vision, hearing, and long-term care.
What does Medigap do for people?
Medigap insurance helps pay for medical costs when using hospitals and medical services.
What are the benefits of Medigap?
There are many benefits of enrolling in a Medicare Supplement plan. They give peace of mind and options for your health care. That’s easy to budget.
Getting help with choosing a Medigap plan
Choosing a Medigap plan can be a daunting process. With ten choices and 20 to 30 insurance carriers, many people look for help when comparing. That’s where we come in. Our licensed insurance agents are here for you.
Let us educate you on the differences and costs. We’ll help with providing comparisons and walk you through the enrollment process. For assistance, call or fill out our online request form.
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