While Original Medicare pays for many of your health care services and supplies, it may not cover everything you need. You may want to consider enrolling in a Medicare Supplement plan, also know as a Medigap plan.
Unlike Original Medicare, Medigap plans are offered through private insurance companies. These plans help cover some of the hospital and medical costs that Original Medicare doesn’t cover such as copayments, coinsurance and yearly deductibles. Some plans also help pay for services such as Part B excess charges, emergency overseas travel, and 2 out of the 10 Medigap plans include a yearly out of pocket limit, all of which Original Medicare does not.
In other words, a Medigap policy can fill in “the gaps” of Original Medicare.
There are currently 10 Medigap plans offered, each one designated by a letter of the alphabet (A, B, C, D, F, G, K, L, M, N; there’s also a high-deductible version of Plan F).
In most states the benefits are the same regardless of what insurance company you choose to purchase a plan from, though each plan covers different things. Premium prices for each one of the 10 plans will vary depending on your age, where you live, the insurer and the type of plan you select. These premium payments are separate from your regular Medicare premiums. In order to be eligible for a Medigap plan you must already be enrolled in both Medicare Part A and Part B. You will need to stay enrolled in Original Medicare for your hospital and medical coverage as Medicare Supplement plans are not meant to provide stand alone benefits. If you have Original Medicare and and Medigap plan, Original Medicare will pay first and then your Medigap policy will fill in the cost gaps.
Here are some quick facts about Medicare Supplement plans:
- Depending on which state you live in, you may be unable to purchase a Medicare Supplement plan if you are under age 65 and have Medicare due to a disability, End-Stage Renal Disease (ESRD) or Lou Gehrig’s Disease. States are not required to offer Medigap coverage to beneficiaries under age 65.
- Medigap plans do not include prescription drug coverage (Part D), so if you are wanting help with your prescription drug costs you will need to enroll in a stand alone Medicare prescription drug plan.
- Medigap policies only cover one person, and so if your spouse needs additional coverage they will need to find their own policy. We can help!
- Medigap policies usually do not cover long term care, vision or dental care, eyeglasses, hearing aids or private duty nursing.
- You cannot be enrolled in a Medicare Advantage Plan and a Medigap Plan at the same time.
- Not all Medicare Supplement plans may be available in your state
- As long as you pay your monthly premiums, Medigap policies are renewable even if you develop health problems. Your insurance carrier cannot terminate your policy.
Now that you know a little more about Medigap plans, you may be wondering if one of these plans is right for you.
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