Medicare Supplemental Insurance

September 8, 2011

Healthy Life

Medigap Policy – Medicare Supplemental Insurance

What is a Medigap (Medicare Supplement Insurance) policy?

Medicare Supplemental Insurance is a policy provided by private insurance companies that fill the gaps in coverage that your basic Medicare Part A and Medicare Part B do not cover. Medigap policies can help pay your share (coinsurance, copayments, or deductibles) of the costs of Medicare-covered services. Some Medigap policies also cover certain benefits Original Medicare doesn’t cover.

Medicare Supplemental Insurance

Medicare Supplemental Insurance

The Different Parts of Medicare

The different parts of Medicare help cover specific services:

Medicare Part A – Hospital Insurance

  • Helps cover inpatient care in hospitals
  • Helps cover skilled nursing facility, hospice, and home health care

Medicare Part B – Medical Insurance

  • Helps cover doctors’ services, hospital outpatient care, and home health care
  • Helps cover some preventive services to help maintain your health and to keep certain illnesses from getting worse

Medicare Part D – Medicare Prescription Drug Coverage

  • A prescription drug option run by Medicare-approved private insurance companies
  • Helps cover the cost of prescription drugs
  • May help lower your prescription drug costs and help protect against higher costs in the future
Medigap policies don’t cover your share of the costs under other types of health coverage, including Medicare Advantage Plans, stand-alone Medicare Prescription Drug Plans, employer/union group health coverage, Medicaid, Veterans Administration (VA) benefits, or TRICARE.

What Medigap policies cover

 

Medigap exists to cover services that Original Medicare does not. In that they can help Medicare recipients with their health care costs. It is also possibly worth checking into Medicare Advantage Plans and comparing their costs with the costs of Original Medicare and a given Medigap plan.

There are 11 standardized Medigap plans including one high-deductible standardized plan. Each of the 11 plans has specific benefits that are defined by federal law. Because the law standardizes all Medigap plans, the benefits of a particular plan (Medigap Plan A, for example) do not vary from insurance carrier to insurance carrier.

Medigap policies are supplemental medical insurance that covers the gaps in Original Medicare. It can be useful health insurance coverage for those with Original Medicare. But whether or not buying a policy makes sense depends on your personal medical circumstances. It can also depend on the plan.

What Medigap policies don’t cover

 

Medigap policies don’t cover long-term care – like care in a nursing home, vision or dental care, hearing aids, eyeglasses, and private?duty nursing.

 

What do You need to knowbefore You buy a Medigap policy?

  • You must have Medicare Part A and Part B to buy a Medigap policy.
  • If you have a Medicare Advantage Plan, you can apply for a Medigap policy, but make sure you can leave the Medicare Advantage Plan before your Medigap policy begins.
  • Plans E, H, I, and J are no longer for sale, but you can keep these plans if you already have one.
  • You pay the private insurance company a monthly premium for your Medigap policy in addition to the monthly Part B premium that you pay to Medicare.
  • A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you each will have to buy separate Medigap policies.
  • You can buy a Medigap policy from any insurance company that’s licensed in your state to sell one.
  • If you want to drop your Medigap policy, contact your insurance company to cancel the policy.
  • Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can’t cancel your Medigap policy as long as you pay the premium.

Which Medigap Plan is Best for You?

 

There are various Medigap plans. They all cover Part A Hospital costs up to 365 more days after Medicare hospital costs are used up. The same is true of coverage for; the first three pints of blood you use in the hospital, Part A hospice care coinsurance and copayments. All of the Medigap plans also cover Medicare Preventive Care Part B Insurance and they all do so at a rate of 100 percent.

Not all of the plans cover Skilled Nursing Facility care coinsurance. Nor do they all cover the deductible for Medicare Part A. Even fewer cover the Medicare Part B deductible. Medicare Part B Excess Charges are likewise only covered by two of the available plans.

You have to pay close attention to how your Medigap premiums are set. How the prices are set can determine not only how much you pay now but how much you may wind up paying in the future.

Foreign Travel Emergencies are covered to 100% by six different plans. These should be considered by people who travel extensively. Medicare doesn’t offer extensive service outside the USA and its territories.

More info about Medicare Supplemental Insurance


This site is for information and support only and NOT a substitute for professional diagnosis and treatment!
Insurance, Medigap

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