There are many medical expenses that Medicare does not cover in full which leaves the patient with a sometimes substantial bill. For this reason people were allowed to obtain a private supplemental health insurance offering to those who are currently on Medicare and choose to opt into a policy that will help bridge the payment gap. Medigap was created to help pay things like deductibles, coinsurance, and co-payments. Currently, about one fifth of Medicare beneficiaries have chosen to enroll in such a plan.
There are ten different plans offered each with their own benefits. The type of plan chosen really depends upon the individual situation as some plans have lower deductibles and are recommended for those who are generally in good health while other plans cost more initially but pay more of the gap. These plans are generally recommended for those who are turning 65 and may have some preexisting conditions that make such a plan a necessity. Some of the most popular plans are F, C, G, and N.
Medigap Plan F
This is the most comprehensive plan as it covers everything that Medicare covers along with some helpful supplemental services for seniors. For instance, a deductible for hospitalization in plan F can substantially lower the out of pocket cost of hospital visits. Other benefits include: emergency help for traveling abroad, extra charges from doctors, and deductible options. Plan F covers 100 percent of other charges so that the patients have no bills to pay including no co-pays. It is an ideal choice for those who are able to pay the deductibles.
Medigap Plan C
Plan C is quite similar to F as it also offers the majority of the comprehensive benefits discussed above. However, the one major difference is that it does not cover excess charges by practitioners under Part B of Medicare. Plan G is another popular option and it is lower in cost than plans C and F but it does not help cover the Medicare Part B deductible in any manner. Finally, Plan N is the third most popular plan among Medigap plans, which is similar and even less expensive except that it does cover excess Part B charges or the Part B deductible.
Medigap Plan G
Medigap Plan G is exactly like Plan F except you must pay the annual Part B deductible yourself each calendar year, prior to Medicare Part B paying anything on your behalf. This amount is very near to the $150 mark and once you pay this out-of-pocket, Plan G will pick up 100 percent of the gaps of Part A and B. The benefit of you taking on the responsibility of paying this is that it results in lower monthly premiums to you. In fact in nearly every case you will end up saving more money by going with a Plan G over plan F.
Medigap Plan N
Medigap plan N was introduced in 2010 and has gained popularity ever since. Offering excellent coverage, it is slightly different than plan G. With Plan N you still must pay the Part B deductible, however after you do with each doctor’s visit within the calendar year you might have up to a $20 co-payment. This is not guaranteed as you might have no, or a small co-pay. It just depends on why your visiting. As well with Plan N if you visit the emergency room but you are not admitted you will incur a $50 co-pay. This plan also does not cover Part B excess charges.
In order to be eligible for any of the aforementioned plans, one must be currently enrolled in Medicare Part A and Part B. Enrollment during the first six months of turning 65 does not require any sort of medical screening as it is the open enrollment period. However, after this period of time in most cases a medical examination will be required prior to enrollment. On some occasions, those who are under 65 and beneficiaries of Medicare Part A and Part B can enroll but they always require an exam first.
Medigap is not that same as Medicare Advantage. Those types of plans take the place of Part A and B and you must visit doctors within the network’s coverage system to be eligible for benefits, where as a supplement policy has no network. You can visit any doctor in the country that accepts Medicare with a supplement, and many plans even include a foreign travel benefit.
There are many reasons that Medicare beneficiaries choose to purchase Medigap. In almost all cases, the plans save money in the long run and provide a comforting sense of safety for seniors who will likely require additional care as they get older. In addition, there are so many diverse plans to choose from that there is truly something for everyone. Our experienced advisors can easily assess your personal situation and show you a comparison of the plans that will fit your needs.