What Is A Medigap Policy (Medicare Supplement Health Insurance)

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  • August 26, 2020
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Everything You Need To Know About Medigap Policy

What Is A Medigap Policy (Medicare Supplement Health Insurance)

 

After turning 65, you become eligible for the government-run healthcare plan, Medicare. From hospital bills to home care, Medicare covers your expenses, but to some extent. This is where Medigap policy or the Medicare Supplement Health Insurance comes into play.

Since Medicare doesn’t pay for all of your expenses for health care services and supplies outside the plan, the ‘gaps’ are filled with this Supplement Insurance, where it pays for these outside expenses. Generally, Medigap is sold by private insurance companies.

If you already have Original Medicare and want to expand your health care benefits with Medigap, read on below to learn everything you need to know.

 

Things To Know When You’re Going To Buy A Medigap Policy

 

  • If you have Original Medicare along with Medigap policy, each of them will pay their share for the healthcare costs covered in their individual plans.
  • An insurance company will only sell you standardized Medigap supplement insurance, which follows the state and federal laws.
  • Medigap will help you cover the copays, coinsurance, and deductibles left by Medicare.
  • However, to buy a Medigap policy, you must have enrolled in Medicare Part A and Part B.
  • You will have to pay Medicare premium for Part B.
  • You will also have to pay for the Medigap premium to the insurance company. When you pay the premium annually, your Medigap policy will be renewed each year.
  • While you can choose from 10 types of supplement plans, you must know that the Medigap is different from the Medicare Advantage plans, as the latter helps you get Medicare benefits, while the former supplements your Original Medicare.
  • When buying a Medigap supplement plan, know that it provides coverage for only one person. If you want to buy it for your spouse, you both will have to get separate policies.
  • No one can sell you a supplement plan if you are already enrolled in the Medicare Advantage plan. You’d only be eligible for that if you’re switching back to Original Medicare.
  • Some supplement plans offer prescription drug coverage. Otherwise, you have to join Part D if you want a prescription included.
  • You must compare Medigap policies before buying because the costs can vary from one insurance company to another.

 

What Does It Cover And What It Doesn’t Cover

 

Medigap plans offer a versatile range of coverage that varies from one plan to another, which are listed below:

  • Part A coinsurance and hospital expenses (up to a year after Medicare benefits are used)
  • Part A hospice care coinsurance and copays
  • Part B coinsurance and copays
  • Skilled nursing facility care coinsurance
  • First three pints of blood
  • Part A and Part B deductibles
  • Part B excess charges
  • Foreign travel emergency (as per the plan’s limits)

While Medigap policies cover the above areas, these don’t cover long-term care (e.g. non-skilled nursing home care), dental or vision care, hearing aids, spectacles, or private nursing.

 

Insurances That Aren’t Medigap Policies

 

Medigap doesn’t entertain some kinds of insurances, which are as follows:

  • Medicare Advantage Plans like HMO, PPO, and others.
  • Medicare Prescription Drug Plans
  • Medicaid
  • Employer or union plans
  • Long-term care insurance policies
  • Veterans’ benefits
  • TRICARE
  • Indian Health Service, Tribal, and Indian Health plans
  • Qualified health plans sold in the health insurance market

Before you take the Medigap policy, we suggest you talk to your local insurance agent to get detailed information about the plan of your choice.

 

How To Find A Medigap Policy

 

As discussed above, you must have enrolled in the Original Medicare to have your Medigap policy. Medicare will pay for some parts, but then, this special insurance will cover the extra costs. Here is a step by step method to find your desired Medigap policy.

 

Step#1 Search And Decide For The Policy You Want

Policies coming under Medigap are standardized, making them ten as per their distinct offerings. Depending on your need, you can compare the benefits in each plan.

 

Step#2 Choose Your Plan

Once you’ve decided on the plan, find the policies offered in your area. Several insurance companies might offer the same plans, but at different rates.

 

Step#3 Contact Your Insurance Company

Now, it’s time to get a quote from the company that provides you with the most feasible plan prices. However, keep in mind that the prices may be subject to fluctuation depending on the time of plan purchase, your health condition, and so on. When you’re ready to buy your policy, contact the company.

 

Step#4 Use The Medicare Website To Find The Policies In Your Area

If you think it’s hard to find an authentic company in your locality, you may visit the Medicare Supplement official website to find the companies. Here, you would only have to enter your zip code, and the list of licensed insurance companies will display on your screen.

 

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