Medigap Insurance Tips

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Determining Your Medigap Premium

For many, age 65 means taking advantage of Medicare open enrollment. Medicare offers people 65 or older who are U.S. citizens low cost health coverage. In many cases those under 65 who are disabled or have renal failure may also qualify. In addition to Medicare, many people consider additional coverage called Medigap.

Designed by the government as supplemental health insurance that covers the costs that Medicare does not cover, a Medigap premium is payable for each person that is enrolled in Medicare Part A or part B. This type of policy only covers the primary insured person, so spouses or each person must have their own individual Medigap policy.

Medigap insurance is broken down into several categories and the Medigap premium will differ from policy to policy. All policies offer co-insurance for hospital visits and all plans except Medigap Plans K and L will offer co-insurance for Medicare Part B such as doctor's visits and diagnostics. Plans K and L are designed for a lower monthly Medigap premium and coverage for Medicare Part B, blood products, and hospital deductibles are only covered at 50% for K and 75% for L.

Medigap Plans F and J are also policies that may offer lower premiums, but the deductible for these policies may be as much as $2000. All Medigap policies cover preventive care and some even cover care outside the US or include an at home recovery benefit.

All Medigap Plans have been standardized by the federal government. While many companies offer Medigap insurance, these companies can also choose what Medigap Plan they want to or don't want to sell. The Medigap premium will vary depending on the Plan chosen and the geographic region the policy is purchased in.


Purchasing Medigap Supplemental Health Insurance

Medigap supplemental insurance covers out-of-pocket expenses that Medicare does not cover. It is supplemental insurance purchased from private insurance companies.

* The best time to purchase Medigap insurance is during your Medicare open enrollment period, which begins on the first day of the month when you turn 65 years of age.
* Shop around. Because different private insurance companies charge different amount for Medigap insurance policy plans, it is important to compare available plans and coverage before deciding on one that meets your needs. There are ten plans, named A through J -- each plan has different benefits and coverage, so do your homework before or during your Medicare open enrollment period.
* Consider joining Medicare Prescription Plan (Part D). Medigap supplemental insurance does not cover prescription drug coverage, so you'll need to obtain medication coverage elsewhere.
* Medicare Part A and Medicare Part B are required to purchase a Medigap policy.
* Hospice Part A coinsurance is now covered under Medigap supplemental insurance policies.
* Medicap policies only cover one person. If you are married, you and your spouse BOTH have to purchase Medigap policies if you both want supplemental coverage. Medigap policies don't cover nursing home care (long-term care), dental, vision, eyeglasses or hearing aids. Private-duty nursing is also not covered.
* Medicare Advantage Plans (i.e. Part C), Private Fee-for-Service Plan, Medicare Prescription Drug Plans (i.e. Part D), Medicaid, Veterans Benefits, long-term care policies, employer or union plans are not Medigap Plans.

For more information about Medigap supplemental insurance, refer to the 64 page government-sponsored brochure titled Choosing A Medigap Policy: A Guide To Health Insurance For People With Medicare by visiting or by calling 800-633-4227.


Medigap Insurance

Many people age 65 or older are eligible for Medicare coverage. Whether they have Medicare Part A or Part B another type of supplemental health insurance they should give consideration to is Medigap insurance coverage.

Medigap insurance is coverage that is defined by the federal government, but sold by third party insurers. Medigap insurance is broken down into several plans labeled Plan A through Plan N. The correct medicare forms to be used for this type of insurance can be found through the Social Security Administration, Medicare, or any approved Medigap insurer.

Of the Medigap insurance plans in place, the cost for each will vary by geographic region and unlike other health insurance policies that cover a spouse or loved one, each insured person must obtain and pay the premiums for a separate Medigap insurance policy. Medigap is supplemental coverage to Medicare, so to qualify to purchase this type of policy, the insured must first be enrolled in Medicare Part A or Part B.

A recent change to Medigap insurance involves prescription drug benefits. If you already have a Medigap policy that covers prescription drugs, you may keep it, but Medicare recommends that all Medigap drug policies be cancelled and switched for a Medicare Part D prescription drug plan. Most Medigap prescription drug plans are not creditable.

All new Medigap plans will no longer offer prescription drug coverage and insured people who have Medigap drug coverage and switch to Medicare Part D will have the Medigap drug coverage discontinued and their premiums adjusted to show that.

Medigap should be considered by all who are eligible because though Medicare offers good coverage for those over 65, it does not cover everything and could leave the patient with substantial bills to pay if an illness strikes.


Considering the Need for Medigap Premiums and Policies

Seniors evaluating health insurance coverage options should be sure to consider the addition of Medigap premium costs and coverage policies to their health coverage mix. Medigap policies are sold by private companies and provide coverage to fill the gaps found in traditional Medicare coverage. Medicare policies do not necessarily cover all of one's health care costs, so many seniors opt to pay Medigap premiums to enhance their coverage and reduce unexpected out-of-pocket expenses.

While Medigap policies are sold by private companies, they are standardized with specific benefits, so they should be easy to compare between companies. There are 12 different Medigap coverage policies, named Medigap Plans A through L, which provide slightly different levels of coverage from plan to plan. The Medigap premium for each plan will differ from company to company, so it is important to consider and compare multiple companies to ensure the plan you choose is the best possible fit for your needs.

While a Medigap policy is not required coverage, many seniors feel the cost of a Medigap premium is a minor expense that is worth having in place. Navigating the path of Medicare plans and coverage can be confusing, and there are numerous costs and procedures that are not covered by a basic Medicare plan. This is where the health insurance coverage provided by a Medigap policy can provide both a helpful financial safety net and significant peace of mind.


Medigap Insurance Options Tips for Medicare Patients

The original Medicare plan does not cover all health care services needed by the typical American. While it does pay for many expenses, you are responsible for the unpaid bills for the services that are not covered by Medicare.

This is where a Medigap insurance policy comes in handy. Available for sale by private insurance companies, a Medigap insurance policy can help absorb the expensive health care bills that you are responsible to pay.

The name Medigap derives from the fact that it pays the gap of unpaid costs not covered by the Original Medicare plan, such as co-payments, coinsurance and deductibles.

Each and every Medigap insurance policy is governed by Federal and state laws that must be followed. Each policy must be clearly identified as “Medicare Supplement Insurance.” Medigap insurance companies are further regulated and can sell you only a standardized Medigap policy. The plans vary by benefits and so you are able to choose the Medigap insurance policy that best meets your needs.

In addition, a good Medigap insurance plan to secure is a policy that also offers coverage for services that Original Medicare doesn't cover. Most folks may not be aware that medical care when you travel outside the U.S. is not provided with the Original Medicare plan, so this is an option you would certainly want in a Medigap policy.

One additional note; you are responsible for the premiums for the Medigap insurance policy and no part of these premiums is covered under any Medicare plan.


Supplemental Insurance

In addition to standard health insurance policies many people may want to consider supplemental insurance. Many standard insurance policies include co-pays that are paid at the time of your visit to a doctor or hospital or even a diagnostic clinic or lab. Other health insurance policies have deductibles that must be paid prior to coverage kicking in.

Higher deductibles are usually a trade off for lower monthly premiums, but when medical attention and care is needed, many find that they can't afford to pay the deductible or co-pay and must arrange payment plans. Supplemental insurance is a type of policy offered that fills the gap between regular coverage and ancillary costs.

Often supplemental policies will also cover or allow their benefits to be applied toward living expenses or other bills. Although they require payment of an additional monthly premium, supplemental insurance should be considered by parents with young children who may be financially strapped if their health concerns prevent them from earning a paycheck.

People over 65 may also be candidates for this in addition to their Medicare health insurance coverage so that they may afford prescription drugs, home health care or care in a skilled facility following major medical or life altering instances. There are many approved third party insurers who will cover the gap between the coverage Medicare offers and additional health insurance expenses.

Supplemental health insurance premiums will vary due to the amount of coverage, pre-existing medical conditions and actual medical conditions covered by the supplemental policy. Health insurance coverage is very important for anyone, but often the additional expenses not covered by these policies are overlooked and cause undue financial stress. Supplemental insurance offers a peace of mind knowing that expenses will be covered when money is thin.


Pointers for Securing the Right Medigap Health Insurance Policy

Medigap health insurance, which is Medicare supplement insurance, offers Medicare participants an affordable way to cover the costs of unpaid medical bills that are not covered by Medicare. There are several plan options that are available for your purchase to help ease the cost of health care costs.

First, you may not be aware that there is a 6 month Medigap policy open enrollment period which begins during the first month you turn 65 and are enrolled in Medicare Part B. This open enrollment period guarantees you the right to buy any Medigap policy available to you in your home state.

In fact, the best time to buy a Medigap health insurance policy is during the 6-month open enrollment period. If you wait until after this special enrollment time frame, your options may be somewhat limited and the cost of the policy may increase. It is also important to promptly purchase Medigap health insurance policies because the rates usually go up as you get older.

When purchasing Medigap health insurance plans, it is helpful to know that the plans are identified by universal designated letters that indicate the type of plan coverage they provide. Be sure to check various insurance companies that offer Medigap health insurance policies, as the rates can vary by company for the exact same coverage. While comparing prices for individual insurance coverage make sure you are comparing the same exact Medigap policy to ensure you get the best deal. For example, when asking for rates, you should compare Plan A from one company with Plan A from another company.


Understanding Medigap Supplement Plans

Medigap supplement plans are provided by private insurance companies and help pay health care expenses not covered by traditional Medicare. These costs include expenses such as coinsurance, deductibles and copayments. There are several Medigap plans, labeled Medigap Plans A through N, which one can choose from while setting up Medicare coverage. Each plan is standardized and regulated in the benefits it provides, though the prices will vary between plans and companies. When considering a Medigap plan, evaluate the coverage provided in each plan and how it will best reduce your potential medical expenses.

You can enroll in Medigap supplement plans via the Medicare forms used during your initial enrollment. If you choose not to add a Medigap plan upon your initial Medicare enrollment, you may be able to add it later though you may find limitations in place. It is also important to consider that certain types of care are not covered in a Medigap policy, such as vision and dental care, private-duty nursing and long-term care such as nursing home costs.

If you choose to add a Medigap policy to your health coverage, you pay a separate premium in addition to your Medicare premium. As long as you pay the premium, the company is required to continue your policy regardless of any new health problems. While Medigap supplement plans are not required with a Medicare plan, many seniors find the plans provide helpful coverage that reduce unexpected out-of-pocket costs. The best time to enroll in Medigap supplement plans is during your initial Medicare enrollment period, and you can enroll while filling out your other Medicare forms.


Supplemental Insurance for Seniors

Supplemental Insurance policies, also known as Medigap policies, are used by insurance companies to provide coverage to their customers in between Original Medicare Plan coverage. These supplemental insurance policies help pay for health care costs that are not covered by the Original Medicare Plan. If you are enrolled in an Original Medicare Plan and have a supplemental insurance plan, both plans will pay their shares of covered health insurance. One of the biggest downfalls of a supplemental insurance policy is that it will not cover any health care costs for your spouse.

All insurance companies must offer Medigap policies that are similar in coverage to each other so customers can research plans and pick the one they feel is best for them. It is possible that you might be able to choose from 12 different Medigap plans for medicare open enrollment. The 12 plans are known as Medigap plans A through L. These policies have to follow state and federal laws for them to be legal. These plans must also be clearly labeled on the front as 'Medicare Supplement Insurance.'

All 12 plans have varying sets of basic and extra benefits. The cost of Medigap plans will vary, which is why you should research and review all 12 plans before making a choice as to which one you will purchase. Your insurance company might not offer all 12 Medigap plans, which is why you should ask your insurance company which plans they offer and if they could send you information.

You can only acquire a Medigap plan if you have a Medicare Part A and Part B plan. You will also have to pay a premium for the Part B plan and the Medigap plan.


Tips for Understanding Medigap Health Insurance Coverage

Trying to learn the “ins and outs” of the complex Medicare benefit program can be overwhelming. Which "Parts" do I need? What are the deadlines? Do I need additional health insurance coverage? Here are some facts about Medicare benefits that may help you sort through all of the programs:

You may want to consider purchasing a Medigap health insurance policy to cover costs not included with your Medicare benefits. Some folks think that a Medigap health insurance policy provides coverage for the entire family, but this type of policy only covers one person, so spouses must purchase separate individual insurance coverage.

For those who have a Medigap health insurance policy and join a Medicare Advantage Plan such as an HMO or PPO, may want to consider dropping the health insurance coverage provided by the Medigap policy. You may not realize that the Medigap policy cannot be used to pay your Medicare Advantage Plan co-payments, deductibles and premiums, so it is basically wasted money spent on these premiums.

Also be aware that if you decide to cancel your Medigap health insurance policy to join a Medicare Advantage Plan, you probably will not be able to have it reinstated at a later date. In addition, it is illegal for anyone to sell you a Medigap policy unless you're switching back to Original Medicare.

If you do decide to change your Medicare benefits and choose to purchase a Medicare Advantage Plan, and then later decide you are not happy with the new plan, you do have special rights to purchase a Medigap policy if you return to Original Medicare within 12 months of joining.


When Can You Buy Medigap Coverage?

Medigap supplement plans are private insurance policies that help cover medical expenses that are not covered by Medicare. There are 14 Medigap plans available, known as Plans A through M. The best time to buy a Medigap plan is during open enrollment, which is the six month period after you turn 65 and are enrolled in Medicare Part B. During open enrollment, insurance companies cannot consider your quality of health when determining the price of your plan. They are also not permitted to make you wait for coverage or to decline to sell you any of the Medigap supplement plans that they offer. You may, in fact, wish to apply for a Medigap policy no more than two months before your 65th birthday, in order to maintain continuous coverage if you have health insurance that expires when you turn 65.

If you do not buy during open enrollment, it is still possible to buy a plan later, but certain restrictions will apply. For instance, an insurance carrier can refuse to sell you a plan based on health issues. They are also allowed to charge clients with health problems more than they charge healthy clients. There are also a number of situations where you have a guaranteed right to purchase Medigap, such as when other comparable group or individual insurance coverage is ending.

By making sure that you buy coverage as soon as you are able, you have the best opportunity to ensure that your health care costs are taken care of.


What To Consider When You Compare Medigap Plans

When you sit down to compare Medigap plans for the first time it may be confusing, all plans with the same letter provide the same coverage. These plans are labeled with letters from A-N. Different insurance companies however, still will charge different rates for the same plan. When you find one that seems acceptable or have narrowed it down to two or three plans it is wise to check with your state insurance board to see if the companies have had any complaints against them.

If you are starting to compare Medigap plans it is counterintuitive to choose the higher priced plan if you have a lower income but does make sense in the long run. People who have a higher income and can pay part of their medical expenses can take the risk of choosing a policy with lower premiums.

People who have more health problems should compare Medigap plans closely for the extra benefits they may offer. Some health conditions may warrant more tests while others may require skilled care or frequent hospital visits. If you or your spouse presently has a condition or has a genetic predisposition for some conditions take them into consideration when choosing your plan. Another factor to take into consideration is the amount of foreign travel you do or plan to do. Not all Medigap plans cover foreign health costs for emergencies.

Some states offer SELECT plans which are cheaper but only allow you to go to a certain doctor or hospital. It is wise to check and see if your state offers these plans. Also Massachusetts, Minnesota, and Wisconsin have different rules and choices than other states. If you have a Medicare Advantage Plan you will not need a Medigap policy.


Medigap Supplemental Insurance: For Those Times When Medicare Stops

While Medicare is an excellent resource for the millions of Americans currently enrolled in the plans it offers, it simply doesn't cover every medical situation. People who are enrolled in Medicare Part A (which covers hospital services) and Medicare Part B(which covers non-emergency medical care such as doctor visits) plans may still find that they need additional coverage. That is where the Medigap supplemental insurance plans can be a valuable resource: It literally fills the "gaps" that standard Medicare plans do not cover. This may include hospital or doctor copayments, additional hospital benefits and expanded hospice care benefits.

There are 14 different Medigap supplemental insurance plans as of 2010, each with its own benefits and deductibles. Since the Medigap insurance is issued by a private insurer, enrolling in a Medigap plan is purely voluntary and will require a monthly payment. The payment for Medigap plans can vary widely, with the high deductible plans offering the lowest monthly premiums. While completing all the medicare forms can get overwhelming for many people, it is important to remember that enrolling in Medicare Part A and Medicare Part B is essential before you enroll in any of the Medigap supplemental insurance plans. People who are enrolled in the Medicare Advantage plan, also known as Medicare Part C, are not eligible for Medigap supplemental insurance.

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