Medigap
Medigap is popularly known as Medicare Supplement Plans. These plans provide additional coverage with the Original Medicare plan.
They are different from the Medicare Advantage plans which offer almost the same benefits as the Original Medicare plan. There are 10 different types of Medicare Supplement Plans available. Their names 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 Plan G
- Medicare Supplement Plan K
- Medicare Supplement Plan L
- Medicare Supplement Plan M
- Medicare Supplement Plan N
All these plans have different features with the same basic benefits and are also standardized by the law of the federal government. These plans are sold with the laws of the state but all the rules are different for Wisconsin, Massachusetts, and Minnesota.
Enroll in Medigap Plans
To apply for a Medicare Supplement plan, you need to make sure that you meet the following criteria:
- Permanent residency of the state from where the Medigap policy is purchased
- Must already have a valid enrollment of Medicare Part A and Part B
- The age of the subscriber has to be 65 years or above. However, in certain conditions of disability or End-Stage Renal Disease (ESRD) there is a relaxation of age and under 65 years are also eligible for the policy
Coverage of Medigap Plans
Medigap or Medicare Supplement plans are sold by private insurance companies with the consent of Medicare. These plans provide additional support for the healthcare expenses that are not covered by the Original Medicare plan. The coverage includes:
- Medicare deductible
- Coinsurance
- Hospital cost
- Skilled nursing facility
- Foreign travel emergency cost
As these plans cover healthcare expenses of only one person so it is necessary to purchase a Medicare Supplement plan for every eligible individual. Before January 1, 2006, Medigap use to offer coverage for prescription drugs as well but now this has been included in a separate part called Medicare Part D. If you need benefits for your drug cost, then there is an option to purchase Medicare Prescription Drug Plan that offers you complete coverage for it.
Usually, Medicare Supplement Plans do not offer coverage for any long-term care or treatment, vision, hearing, or dental expenses.
Choosing a Medigap Plan
As is mentioned above the Original Medicare plan does not offer coverage for all the out-of-pocket expenses and for that you need to purchase a supporting plan that is Medicare Supplement plan or Medigap. When you subscribe to both of these plans (Original Medicare and Medigap), you can avail of comprehensive coverage that lowers the burden of paying the expense from your pocket. Every Medigap plan has different characteristics but for extensive coverage, Medicare Supplement Plan F is the best option.
However, the network of Medicare Advantage plans is almost the same as it requires the same channel to visit a doctor or hospital. Whereas, the combination of the Original Medicare plan and Medicare Supplement plan will provide a broader network for the medical services.
Once you are eligible, Medigap policies also give you an option to decide whether you want to stay with the policy or switch to any other during the open enrollment period. These 30 days are called the “free look period”.
Cost of Medigap Plans
The cost of Medigap plans varies from plan to plan and company to company. These prices are calculated on the basis of factors like age and geographical location. although the basic benefits remain the same for each plan, no matter from which company these plans are purchased.
How to Purchase Medigap Plans?
When you decide to purchase a Medigap plan, and your age is 65 or above then it is recommended that you get yourself enrolled during the six-months open enrollment period that is pre-decided by Medicare. In case you miss this period, you might have to purchase the policy at a higher rate, or your application to purchase the policy gets rejected. In that situation, you will have to wait for the next open enrollment period.
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