What is Medigap
Medigap is another word used for Medicare Supplement insurance. These policies work right alongside original Medicare which consists of Medicare Part A and Part B.
Medigap plans help to pay for the expenses that are not covered by the Original Medicare plan. Those expenses include:
These are items that you are required to pay prior to Medicare paying any of your medical bills.
Medicare Part A – Hospital Coverage
Part A covers any costs when you are admitted to the hospital. A Medigap plan can help pay for the Part A deductible as well as hospital coinsurance and hospice care.
Medicare Part B – Doctor’s Services
Part B covers many doctor’s visits and outpatient services. Before Medicare begins paying any doctor’s bills or its portion of them, you’re required to pay the annual Part B deductible each year. Once this deductible is met, Medicare will begin paying 80% of your medical bills. Your Medigap plan will pay the remaining 20%.
There are 12 Medigap insurance plans, which are available in all the 50 states of the United States except Minnesota, Wisconsin, and Massachusetts.
Every Medigap Plan helps seniors to pay for their healthcare expenses and give them peace of mind in case they want any medical service or have an emergency.
New subscribers of Medicare plans are often surprised to hear that they will only get 80% of the coverage for Medicare Part B expenses. Whereas, they are required to pay for the remaining 20%.
Sometimes, if a person faces serious injury or disease, the treatment may cost them hundreds of dollars which can be devastating indeed.
To save yourself from those financial complications and the burden on your pocket, purchasing a Medigap Plan would be a great deal. These plans will share that 20% expense with 80% of Original Medicare.
In this way, buying an additional plan could bring peace of mind that if you face any medical emergency then you just need to worry about the treatment, not the expenses.
Compare Medicare Supplement Plan G
Decades ago when Medicare was introduced in the United States, within a short span of time Medigap plans or Medicare Supplement Plans were also available by Medicare.
Basic advantages of Medicare Supplement Plans are:
- You are free to select your choice of doctor or healthcare provider for your medical services
- There is no need to have any reference to when you visit any specific doctor or specialist
- Low out-of-pocket expense and even 0 if you purchase Medicare Supplement Plan F
- Standardized coverage all over the United States
- Renewable – your coverage won’t change because of any reason (poor health condition)
Your inpatient and outpatient expenses are covered almost fully with Medicare Supplement Plan or Medigap plans. Whatever Medigap plan you choose; it is full of benefits for the seniors so they don’t have to worry about the cost when they need healthcare service.
Medicare Part A and Part B copays and deductibles are covered fully or partially with different Medigap plans.
Key things to note about Medigap Plans:
- You must be enrolled in Medicare Part A and Part B before purchasing any Medicare Supplement Plan
- Medigap is offered to individual senior citizens of the United States. However, if you need a supplement plan for your spouse also, then you are required to purchase a separate plan for your partner as well
- You have the right to drop or switch to some other plan and are not restricted to keep your Medigap plan throughout the year
- The annual election period is only for drug plans however there is nothing to do with Medigap plans
- There are some spouse, family, or group discounts offered by many private insurance companies when the supplement plans are purchased from the same company
- If you want the coverage for prescription drugs also then you have to purchase Medicare Part D as this is not included in any of the 10 Medicare Supplement plans
Medicare Supplement Plans - Coverage
Coverage of Medicare Supplement Plan
Medicare insurance policies work with the collaboration of the federal government and the Original Medicare policy can only be purchased from Medicare directly.
However, Medicare Supplement insurance policies are offered by private insurance companies who are licensed to sell these plans.
As the coverage of Medigap plans is standardized by Medicare itself, which means you will get the same level of coverage for the expenses whether you purchase it from company X or company Y in any 50 states of the United States except Minnesota, Wisconsin, and Massachusetts.
These three states have their own standardized plans with limited options, which makes it for the seniors of that state easier to choose a plan for their healthcare expenses.
Medicare Supplement Plans pays its share of expenses after Medicare has paid and approved the share for your healthcare service claim.
What is meant by a standardized Medicare Supplement Plan?
Another plus point of enrolling in a Medicare Supplement Plan is that you don’t have to worry if you live in more than one state throughout the year. As the coverage remains the same and you can avail the benefit of the insurance policy.
To make it more clear. Let’s explain through an example:
If you have purchased a Medigap Plan in Texas and wish to visit your son for 3 months, who lives in Ohio. The coverage for your healthcare needs will be the same as Medicare and its Supplement Plans are accepted in both states.
If you want to know more about the Medigap Plans, you can check the booklet. An e-booklet is also available that is published by Medicare itself. This booklet includes all the details along with FAQs about all the ten Medicare Supplement plans.
Whereas, our website also has detailed information on the Medicare policies including Supplement Plans and Advantage plans.
Compare Medicare Supplement Plan G
Medigap Plan Letters
As mentioned above, there are ten types of Medicare Supplement Plan that offer standardized coverage for the healthcare expenses after Medicare has paid its share. Their titles are as follows:
- Medicare Supplement Plan A
- Medicare Supplement Plan B
- Medicare Supplement Plan C
- Medicare Supplement Plan D
- Medicare Supplement Plan F
- High-deductible F
- Medicare Supplement Plan G
- High-deductible G
- Medicare Supplement Plan K
- Medicare Supplement Plan L
- Medicare Supplement Plan M
- Medicare Supplement Plan N
Among these 12 Medicare Supplement plans, the most comprehensive one is Medicare Supplement Plan F. This plan offers complete coverage of the gaps that are left unpaid by the Original Medicare plan. It offers full coverage for Medicare Part A and Part B but unfortunately, it’s no longer available after January 01, 2020, for the seniors who are eligible to purchase it.
There are high deductible versions of two Medigap Plans, they are:
- High deductible Supplement Plan F
- High deductible Supplement Plan G
Once you reach the high deductible amount that is $2370 in 2021 by paying the deductible, coinsurance, and copayments from your pocket, the plan is now ready to play its part for the rest of the year. All the expenses that are required for your medical services (disease, treatment or surgery, etc) will be covered by this plan now.
For Medicare Supplement Plan K and Plan L, once you hit the yearly out-of-pocket limit and Medicare Part B deductible which is $203 for 2021, your coverage from these plans will start and it will pay for the expenses throughout the year.
For Medicare Supplement Plan N, you are covered fully for Medicare Part B except for the copayments each time you visit a doctor or emergency room. However, the charge for each visit to the doctor is $20 and the emergency room is $50 only, which is not much higher unless your health condition requires frequent visits.
Choosing a Medicare Supplement Plan
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How to choose a Medicare Supplement Plan?
The majority of people prefer to enroll in Medicare Supplement Plan F, G, or N so that they are relieved by making a payment only once as a premium of the plan. These three plans offer maximum coverage for copayments, coinsurance, and deductibles. However, everyone doesn’t need to have the same coverage requirements because the health conditions and services a senior needs differ from patient to patient.
Where some seniors find that paying more premium gives relaxation from out-of-pocket expenses, on the other hand, some find paying a higher premium is costly as their healthcare needs are also covered by a low coverage plan.
It’s always better to discuss your medical condition and service requirement with an insurance agent so that you get a quotation for a few plans that fits the best for your healthcare needs.
Open enrollment period for Medicare Supplements
The six months’ window for registration of Medicare plans is called the open enrollment period (OEP). This period starts from the first day of the birth month of your 65th birthday or the month when you enroll yourself for Medicare Part B and ends right after six months. Either you use it or lose it and if you lose this opportunity then there is a possibility that your application might get rejected due to pre-existing health conditions. As whatever medical complications you have, the insurance company has to issue you a Medicare plan without any question.
You have the right to select your choice of Medicare Supplement Plan to fill the gap left by the Original Medicare plan. Once you purchase the plan, the insurance company cannot cancel the subscription unless you fail to pay the premium on time, the information mentioned in your application is false or the insurance company went bankrupt.
Medigap Plans – Guaranteed Issue
If you do not subscribe to a Medigap plan during the open enrollment period because you already own a subscription to group health coverage from the employer. But, if in case you got retired or switch your job or any other reason due to which you no longer have the group health coverage, then you can get yourself enrolled to a specific Medicare Supplement Plan within 63 days, this is termed as guaranteed issue rights.
This 63 days’ window has similar rules to the open enrollment period. However, this plan has limited plans to offer like Medicare Supplement Plan A, Plan B, Plan C, Plan F Plan K, and Plan L. There is a condition for Medigap Plan F that only the applicant who applied and became eligible before January 01, 2020, can purchase it.
The rules are different for guaranteed issue rights in every state. So, you need to check the rules and discuss them with the insurance agent before making a purchase to avoid healthcare and financial complications.
Medigap Plans – Underwritten
Just in case, you missed purchasing the Medicare Supplement plan during the period of 63 days for guaranteed issue or six months for the open enrollment period, then even you can apply for a Medigap plan but at this point, the insurance company has the right to either accept the application or reject it.
The decision for the application made by the insurer is based on your health condition. Whereas, changing your Medicare Supplement plan from company X to company Y requires underwriting.