What is Medigap? Medigap, also known as Medicare Supplement plans or Medigap insurance plans are additional health insurance that you purchase from a private insurance company to help minimize the out of pocket costs brought about by Original Medicare coverage gaps. Coverage gaps are those healthcare expenses not covered by Medicare (Part A and Part B), such as copayments, coinsurance, deductibles, and medical services if you travel outside the US. Medigap will pay all or part of those healthcare costs that Medicare doesn’t cover.
You have to pay a monthly premium when you buy a Medigap policy. This premium is different from the Medicare Part B premium that you pay to Medicare. The cost of your Medigap insurance plan will depend on the type of plan you buy, the insurance company, location and your age. The policy is renewable despite your pre-existing health problems as long as you pay your premiums on time. Find out here how much Medicare supplements cost.
There are ten standardized Medicare supplement plans offered in the market. Each type offers different levels of coverage and benefits. Plan types are labelled A through N though Plans E, H, I, and J are no longer available to new enrollees.
How Medicare Supplement Plans works
As easy as how the Medigap definition is explained above, here’s how Medicare Supplement works with your Original Medicare:
♦ Original Medicare will pay its share of the covered Medicare-approved health care
♦ Then after Medicare has paid its share, your Medicare supplement plan will pay its part.
What do Medicare Supplements cover?
The basic benefits that Medicare Supplements cover are:
- Medicare Part A coinsurance and coverage for hospital services
- Medicare Part B coinsurance or copayment
- Blood transfusions (first three pints)
- Hospice care coinsurance or copayment
Some plans have extra benefits or additional coverage aside from the ones enumerated above. Note that not all of the plans provide 100% coverage of the basic benefits. Other healthcare expenses that Medigap DO NOT cover are prescription drugs, long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.
Things to know about Medigap Plans
- You must have Medicare Part A and Part B and are already age 65 to enroll in Medigap.
- Medicare supplement open enrollment period comes only once in your lifetime.
- You can apply for a Medigap plan even if you have a Medicare Advantage plan. Make sure that you will leave your Advantage Plan once the Medigap plan begins.
- Medicare Supplement plans are different from Medicare Advantage plans.
Read Next: When can you enroll in a Medigap Plan?
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