Medigap plans (Medicare Supplemental Insurance) are personal health insurance that you may purchase from one of several private insurance companies. The coverage is mainly intended to help cover most or all of any additional medical costs that are not paid under Medicare Part A and Part B. Examples of these costs include the deductibles, co-payments as well as the 20 percent coinsurance that Part B does not cover for physician’s services. Some plans also include emergency coverage when one is out of the country.
Supplemental insurance for Medicare does not include coverage such as dental or vision, however those plans are available. In addition to this, they also do not cover the prescription drugs. You will need to enroll in a Part D drug plan separately if you would like this coverage which most people do.
When applying for supplement coverage, one has to first determine out of the 10 plans available which one fits their needs the best. Contrary to popular belief there is no “one best” plan for everyone. This is simply because everyone has different health situations, and different budgets.
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You first must have both Medicare Part A to cover the hospital services and Medicare Part B to cater for the services of the doctor in order to be considered for a Medigap policy. Most people choose to sign up for their coverage effective the same date as their Part B effective date.
Open Enrollment Period
For most people this will be the best time to sign up for supplement coverage. This is because all pre-existing conditions are waived during this period and no one by law can be turned down for coverage. This period lasts 6 months and begins on the Part B effective date. You do not need to provide any medical information or history and you are guaranteed coverage.
Renewing Medicare Supplement Policies
Medigap Plans are what is called guaranteed renewable. This means that so long as you pay your monthly premium on time they may never cancel your policy based on any reason including your own health claims. Initial rates of your policy are based on the group you are in, along with other factors such as age, zip code, tobacco use, and gender. The rates are not based on your own health condition when applying during the open enrollment period.
Each and every one of the Medigap Plans chosen has its own benefits to the policy holder. The most popular plans available are Plans F, G and N.
Medigap Plan F – Pays 100 Percent of the Gaps
• Covers hospitalization costs by paying a coinsurance cover for 365 extra days after one’s Medicare care has expired
• Covers for three pints of blood per year and medical expenses that include 20% of the total approved Medicare expenses or out-patient copayment services
• Covers the policy holder’s costs for skilled nursing in any nursing facility and medical emergency costs when travelling abroad
Medigap Plan G – Just One Small Deductible
• Payment of the first three pints of blood per year
• Payment of Part B coinsurance that covers 20% of the medical expenses including for the outpatient hospital services (After the annual Part B deductible is met)
• Payment of Part A coinsurance hospitalization which include a 365 additional benefits after the end of one’s Medicare benefits and hospitalization deductible Part A
• 100% Part B Medicare excess charges and an emergency travel abroad emergency cover
• Provision of skilled nursing facility
Medigap Plan N – Small Out-of-Pocket Costs With Lower Premiums
• Part A deductible, hospice co-payments and coinsurance as well as coinsurance for all hospital costs for up to 365 days after the expiry of one’s Medicare benefits
• After you pay the annual Part B deductible you’ll have up to a $20 co-pay
• Emergence foreign travel care, provision of skilled nursing facility and free first pints of blood.
Medigap Plans pay most or all of the deductibles and coinsurance of Part A and Part B. They provide a great peace of mind in knowing your medical bills will be paid. There’s absolutely no reason why you should pay too much for a policy however. We’re here to help. Simply enter your zip code below to instantly compare plans and get online quotes from top carriers in your area.
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