Understanding Medicare Supplemental Insurance

Medicare supplemental insurance, commonly known as Medigap, is a type of health insurance designed to cover the gaps in the original Medicare coverage. These gaps include coinsurance, co-payments, and deductibles that are not covered by Medicare. Medigap policies are sold by private insurance companies to help people with original Medicare to pay for their out-of-pocket costs.

What Does Medicare Supplemental Insurance Cover?

Medigap policies cover a wide range of healthcare costs that are not covered by the original Medicare, these include:

Benefits
Description
Part A Coinsurance and Hospital Coverage
Covers the coinsurance and extended hospital stays not covered by Medicare part A.
Part B Coinsurance and Copayments
Covers the coinsurance and copayments not covered by Medicare part B
Blood
Medigap covers the cost of the first three pints of blood each year
Part A Hospice Care Coinsurance or Copayments
Covers the hospice care expenses not covered by Medicare part A
Skilled Nursing Facility Care Coinsurance
Covers the coinsurance for skilled nursing facility care not covered by Medicare part A

What Does Medicare Supplemental Insurance Not Cover?

Despite the comprehensive coverage provided by Medigap policies, there are still some health care costs that are not covered by the policy. These include:

  • Long-term care
  • Vision and dental care
  • Hearing aids
  • Eyeglasses
  • Private-duty nursing

How Does Medicare Supplemental Insurance Work?

To enroll in a Medigap policy, you must have original Medicare, which includes Part A and Part B. You will also need to pay a monthly premium for the Medigap policy on top of the premium for Part B. Once you have paid the premium, the Medigap policy will cover all or some of your out-of-pocket expenses for the healthcare services covered by the policy.

If you are already enrolled in a Medicare Advantage plan, you cannot enroll in a Medigap policy. You can only enroll in Medigap if you have original Medicare.

How to Choose a Medicare Supplemental Insurance Plan?

When choosing a Medigap policy, there are several factors to consider, including:

  • Coverage options
  • Premiums
  • Company ratings and reviews
  • Customer service
  • Location

Frequently Asked Questions

Who is Eligible for Medigap Coverage?

Anyone who is enrolled in Medicare can apply for Medigap coverage. However, you must be enrolled in Medicare Part A and Part B to qualify.

When is the Best Time to Enroll in Medigap?

The best time to enroll in Medigap is during your open enrollment period, which is the six-month period starting from the month you turn 65 and enrolled in Medicare Part B. During this period, you are guaranteed coverage regardless of your health status, and you cannot be charged more due to any pre-existing health conditions.

What is the Cost of Medigap?

The cost of Medigap varies depending on the insurance provider, your location, and the type of policy you choose.

Can I Switch Medigap Policies?

Yes, you can switch Medigap policies at any time. However, if you switch policies after your open enrollment period, you may be subject to medical underwriting, which means that the insurance company can consider your medical history when deciding whether to accept your application and how much to charge you for coverage.

Can I Cancel My Medigap Policy?

Yes, you can cancel your Medigap policy at any time. However, if you cancel your policy, you may not be able to get it back, and you may not be able to enroll in a new policy.

Should I Choose a High-Deductible Medigap Plan?

A high-deductible Medigap plan can help you save money on premiums, but it may also increase your out-of-pocket expenses. Before choosing a high-deductible plan, make sure you understand the costs and benefits of the plan and compare it to other available options.

Conclusion

Medicare supplemental insurance is an important part of healthcare coverage for people enrolled in original Medicare. With the help of Medigap policies, you can rest assured knowing that your out-of-pocket expenses for healthcare services will be covered. When choosing a policy, consider your options carefully and choose the one that best meets your needs and budget.