While Medicare pays for plenty of medical care services, you will find still many it doesn't cover. The Traditional Medicare Plan does not provide 100% coverage for medical expenses such as deductibles, co-payments, and co-insurance. Therefore Medigap was designed to help pay the costs that Medicare does not cover. Medigap can be called'Medicare Supplement Plans.'
Medigap is additional medical care insurance provided by private insurance companies to cover the gaps in the Medicare Plan. Medigap policies are regulated by Federal and State Laws to be able to protect you as a beneficiary. Medigap policies have to be clearly labeled as "Medicare Supplement Insurance", and the policies are standardized for each State.
Medigap coverage works only in conjunction with a Medicare Plan. Typically, you'll want Medicare Part A and Part B to be able to be entitled to Medigap. Acceptance of one's application is guaranteed if you are 65 or older and apply within six (6) months of one's initial enrollment in Plan B of Medicare. Under certain circumstances pre-existing conditions might be waived. Please ask us for specific details. As Medigap policies only cover one person per policy you and your spouse must each purchase separate policies.
In a few states, you may well be able to select from around 12 different standardized policies (Medigap Plans A through L). Each plan supplies a different pair of basic and additional benefits and is the same for every insurance company. Each Insurance company can decide which policies they would like to sell and set their particular prices, so research carefully so as never to overpay.
Medigap policies no longer cover prescription drugs. You can't have both Medicare Part D and Medigap drug coverage at the same time. When you yourself have a Medicare Prescription Drug Plan (Part D) and a Medigap policy that covers drugs, you then need to inform your Medigap insurance provider to get rid of the drug coverage from your own policy. While Medicare Part D coverage is more beneficial than Medigap drug coverage, you may also decide to keep your Medigap policy with prescription drug coverage instead.
Plans A through J do have more benefits, higher premiums, and lower out-of-pocket expenses. Basic benefits include Medicare Part A and B co-payment or co-insurance, and three pints of blood. Extra benefits may include Skilled Nursing Facility co-insurance, Medicare Part A and B deductibles, Medicare Part B excess charges, foreign travel emergency services, at-home recovery, preventive care, and some may still cover prescription drugs.
Plans K through L have lower premiums and higher out-of-pocket expenses. Basic benefits include Medicare Part A hospital benefits, Medical Part A and B co-insurance or co-pay, blood, and hospice care. Extra benefits include Skilled Nursing Facility co-insurance and Medicare Part A deductibles.
When selecting a Medigap plan, carefully compare each plan and compare different insurer quotes. Make sure you have adequate coverage that meets your needs, but you don't want to pay for more as the advantages of each plan are exactly the same for each and every insurance company.