What is Medigap Coverage?

What is Medigap Coverage?

The Original Medicare Plan which includes Part A and Part B is not sufficient to cover all your medical needs. It leaves out certain gaps that require you to pay out of your pockets in the form of deductibles, co-pays, and co-insurance. Medigap policies are designed to fill in these gaps; that is, to cover the expenses that the Original Medicare Plan does not pay. Medigap policies are offered by private health insurance companies approved by Medicare. With the Original Medicare Plan and Medigap, you can rest assured of financing your medical needs in old age.

Medigap policies are not stand-alone services. They work only with the Original Medicare Plan; you need to be enrolled in Part A and Part B of Medicare. And, it requires each person in the family to have separate Medigap policies since it is a one person per policy coverage. Medigap policies automatically get cancelled if you enroll in a Medicare Advantage Plan which is Part C of Medicare.

Medigap policies are also known as Medicare Supplement policies and they are regulated by federal and state laws. There are twelve different plans identified by letters A through L. These policies are standardized plans that have the same basic benefits across providers. For example, Plan A of two different insurance companies must offer the same standard basic services. They can include additional services, but the common benefits cannot be different. Each of the twelve plans covers a specific medical service. More benefits are included in Plans A through J. The monthly premiums are high for these plans but the out of pocket expenses are considerably less. They cover Medicare Part A and B co-pay and co-insurance, and extra benefits like Part A and B deductibles, Part B excess charges, at home recovery, nursing home co-insurance,  plus preventive care and even the difference between the actual fees and Medicare payments. Some plans used to cover prescription drugs though the recent plans have omitted this service. Plans K through L are low premium, higher out-of-pocket expenses plans. They cover Medicare Part A hospital services, Part A and B co-pay and co-insurance, and hospice care, with additional services like nursing facility care and Part A deductibles.

Individuals are encouraged to enroll in Medigap policies in the open enrollment period as their chances of being approved by the providers are higher at this time. Make comparisons of the different plans offered by different providers with the help of a professional to select the most suitable Medigap for you.

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