Everything You Need to Know about Medicare Supplement Insurance
Original Medicare does not pay for everything. While Original Medicare covers more than half of your health bills, you still have quite a sum to chip in to complete your health bills. That’s where Medicare Supplement insurance (also called Medigap) comes in. It is created to bridge the gap between what Original Medicare covers and your out-of-pocket costs.
So, what does Medigap do, and how does it work? Keep reading to find out everything you need to know about Medicare Supplement Insurance.
Medicare Supplement Insurance: What Is It About?
Medicare Supplement Insurance refers to insurance policy plans that are designed to cover some payment gaps in Original Medicare. They are known as Medigap plans and are sold by private insurance companies. Original Medicare covers much but does not cover all. Medigap covers expenses that you would have otherwise paid on your own, such as copayments, coinsurance, and deductibles.
Although Medigap plans are sold by private insurance companies, they are just as standardized as Medicare plans. There are 10 Medigap plans, from Plan A to Plan N. Generally, all 10 plans offer basically the same coverage. The only difference is in the premium payments that differ from state to state and also from the different insurance companies. However, some Medigap policies offer additional coverage. Hence, in choosing a Medigap plan, you have to choose the one that most meets your needs.
Note that Medigap plans are not part of Medicare but are rather a supplemental type of insurance that covers the out-of-pocket expenses that enrollees are supposed to pay after enrolling for Medicare. Also, some Medigap policies cover costs that Original Medicare does not cover, like health care services outside the U.S.
How Does Medicare Supplement Insurance (Medigap) Work?
First of all, to obtain a Medigap plan, you must have Original Medicare Part A and Part B. This means that if you purchase a Medigap plan after getting Medicare, your Medicare plan will cover its share of the Medical-approved amount for health care costs, and equally, your Medigap insurance policy will cover its share, which is usually expenses that are not covered by your Medicare plan and that would otherwise be out-of-pocket expenses.
That said, to keep your Medigap Insurance running, you have to pay a monthly premium to the insurance company. If you have Medicare Part B, you have to pay the monthly premium for that too. Your Medigap policy is guaranteed renewable and hence, can not be canceled by the insurance company as long as you pay the premium.
Another thing to note is that one Medigap policy covers only one person. If you and your spouse need Medigap policies, each of you will have to buy separate policies.
Generally, Medigap plans do not cover costs like prescription drugs, long-term care, hearing aids, vision care/eyeglasses, dental care, and private nursing services. To get coverage for any of these, you can choose to opt for stand-alone plans like Medicare Part D and other additional coverage plans in addition to your Medigap plan.
What Are the Benefits of Medicare Supplement Insurance?
Medicare supplement insurance is the extra insurance that can cover most of your out-of-pocket expenses even though you already have Medicare Part A and Part B. Most people opt for Medigap plans as additional insurance for their health care costs.
Some of the benefits of Medigap policies include the following:
- Medigap plans cover out-of-pocket costs like deductibles, copays, and coinsurance
- Some Medigap plans can cover up to 80% of emergency health care services outside the U.S
- With Medigap plans, you can choose your preferred doctor or hospital, as long as they accept Medicare patients.
- Some types of Medigap plans can completely eliminate a person’s out-of-pocket costs.
Medigap plans, like Medicare, are standardized. What this means is that all Plans A offer the same coverage in all the states (in Massachusetts, Minnesota, and Wisconsin, Medigap policies are standardized in a different way), and the same goes for Plans B to N. However, the benefits of medicare supplement insurance may differ slightly among available plans.
Who Should Consider Medicare Supplement Insurance?
I bet you may be wondering why you need additional insurance. It is a known fact that original Medicare does not cover all expenses, and in situations of emergencies, you may be left with quite a cost to pay for your health care, despite your Medicare plan. Below are some reasons why you may want to consider the extra insurance that Medicare Supplement provides:
- If you need help with the out-of-pocket costs, you have to pay after your Medicare insurance plays its role
- If you require health care coverage outside the USA.
- If you want a long-term healthcare coverage
- If you desire a broader choice of doctors or hospitals
Getting a Medigap plan gives you and your spouse more health care coverage, and it also reduces the out-of-pocket expenses that your Medicare leaves you with.
When Should Medicare Supplement Insurance Be Considered?
You can buy medicare supplement plans anytime after you turn 65. However, there is an ideal period to purchase your preferred Medigap plan. This period is known as your Medigap Open Enrolment Period (Medigap OEP). After this period, you may need to pay more to obtain any Medigap plan. So, when should you get a Medigap plan?
- Within six months of enrolling for Medicare Part B once you turn 65. The Medigap OEP starts counting immediately you enroll for Medicare Part B, and it cannot be delayed or changed. It is a one-time opportunity.
- Within 63 days of losing health care insurance that provides secondary coverage to Medicare, for example, retiree benefits.
- Within 63 days after your insurance policy provider goes bankrupt
- Within 63 days of losing health coverage if you dropped a Medigap policy because of fraud by the insurance company.
- Within 63 days of losing coverage from your Medicare Advantage Plan because you left its service area or the plan stopped providing coverage in your area
Medicare Supplement Insurance is for everyone that desires extra insurance and a break from out-of-pocket costs. So, be sure to check through the available plans in your area and purchase the plan that most meets your needs.