There are over 66.7 million beneficiaries of Medicare in the country today. Medicare parts A and part B cover only up to 80% of total medical costs. Private and independent insurers usually cover the gap left through offering Medicare supplement insurance covers — hence why this insurance is also known as Medigap.
Medicare supplement plans are vital in filling the gaps in Original Medicare. Medigap helps pay for certain Medicare deductibles, co-insurance, and co-payment costs. It helps reduce the out-of-pocket medical expenses to little or zero cost.
Gaps in Medicare Part A and Part B
Medicare Part A covers for in-hospital and hospice services. Some of the gaps within the policy include:
- Hospital deductibles
- Co-insurance payments after 60 days stay
- Hospital services after the 150 days per spell of illness
Medicare Part B caters for outpatient and physician services. The cover may not reimburse:
- Part B deductibles
- Co-insurance payments
- Balance billing above the approved Medicare charges
It’s important to note that effective January 1, 2020, new Medigap plans will not cover Part B deductibles. This means that Plan C and F will not be available to individuals new to Medicare. If the two plans already cover you, you can continue to keep them.
Standard Policies
There are ten standardized Medigap insurance plans available: A, B, C, D, E, F, G, L, M, and N. The plan under each letter policy is standard. It means the benefits are the same, no matter the insurance firm issuing the plan. For example, Medigap plan F provided in company X is the same as one issued in company Y. The difference is in the premiums charged.
However, the states of Minnesota, Wisconsin, and Massachusetts have different standardization for the Medigap policies. If you are living in these states, consult the local State Health Insurance Assistance Program for more details.
When to Purchase a Medigap Insurance Plan
The best time to buy your preferred Medicare supplement is during the Open Enrollment period. This period begins on the first day of the month that you turn 65 and are enrolled in Medicare. The time lapses after six months.
During this period, an insurance company is prohibited by law to deny you a Medigap insurance cover. You do not have to take a physical examination before choosing your plan. It means the insurer cannot raise rates due to health conditions.
Essential Factors to Consider When Choosing your Preferred Medigap Plan
You may need to compare different Medicare supplement quotes before settling on the right policy for you.
- Cost: While insurance plans are standard, the premiums may vary from one company due to another depending on the package chosen. Take note of your budget limit and whether you can afford the plan in the future.
- Coverage: Different plans cover different gaps in Original Medicare. Look deep into your health care needs and choose the right plan for you.
- Insurance Firms: Multiple health insurance companies offer various standard plans. You may choose to work with captive agents or independent Medicare supplement insurance agents.
Medigap insurance plans are essential in filling the different gaps within the original Medicare policy. Medigap coverages are standard, meaning they’re similar in all insurance companies or brokers. The best option would be to work with an independent Medicare Supplement insurance agent as they work with different insurance firms to create a unique package for you.
