Medigap or Medicare Supplement Insurance is a type of insurance policy marketed as private health insurance. It usually pays the gap between what Medicare Parts A and B compensates for your medical care and what you would have to pay out-of-pocket without it. Medigap policies are sold by private insurers, such as United Healthcare. Medigap policies provide additional benefits that Original Medicare does not cover. These include prescription drug coverage, vision and dental care, and more.
Typically, Medigap coverage will cover the difference between the total cost of medical care and the sum permitted by Medicare. In other words, medical services that are not covered by Original Medicare may be covered by some Medigap insurance. For instance, Medigap will cover your medical expenses when on vacation in another nation.
In general, you need Medicare Parts A and B to purchase a Medigap policy. The law requires that you pay the monthly premium for Medicare Part B; more so, you must pay a payment to the Medigap insurance provider. Your Medigap policy will be renewed yearly as long as you continue to pay your premium. This implies that it is perpetually replenished. Therefore, your coverage will be maintained as long as you continue to pay your payment.
How much are Medigap plans?
Your Medigap plan will cost you a monthly payment through a private insurance provider. You will continue to pay a monthly premium for Original Medicare Parts A and B in addition to this payment. Generally, prices change depending on location and coverage. Expect to pay $100 or more per month for a higher-quality plan in a more cutthroat market or less than $30 per month in a different market.
Who is eligible for Medigap?
You must first sign up for Medicare in order to be eligible for a Medicare Supplement insurance plan. Citizens of the United States or those who have been lawfully residing in the country for at least five consecutive years and meet any one of the following requirements are normally eligible for Medicare Parts A and B:
• 65 years or older
• If you have been diagnosed with end-stage renal disease (ESRD; permanent kidney failure needing dialysis or transplant)
• Generally, once you have collected disability payments for 24 months straight, you are eligible for the Medigap plan.
• Received Lou Gehrig’s illness diagnosis (ALS).
If you have end-stage renal disease (ESRD), you might not be able to purchase the desired Medicare Supplement insurance plan or any policy until you are 65. Federal law does not require insurance providers to offer Medicare Supplement plans to those under the age of 65. However, several states mandate that insurance providers provide Medicare beneficiaries under 65 with at least one type of Medicare Supplement insurance plan.
Medigap vs. Medicare Advantage
If you have Medicare Advantage (Part C) coverage, you might be asking if a Medigap policy is the same thing. The simple answer is No. Once you are eligible, Medicare Advantage plans provide an alternative option to get your benefits. While a Medigap policy’s goal is to fill in the gaps left by Original Medicare, it is only a supplemental kind of strategy.
Once you sign up for a Medigap plan, you are no longer eligible to sign up for Medicare Advantage. Medicare Advantage covers the public portion of Medicare and allows it to incorporate additional benefits, such as pharmaceutical, optical, dental, and hearing aid services.
When deciding between Medicare Advantage and Medigap plans, you should consider a number of things, including your income, preferred doctors, assets, medical history, expenses, health, travel plans, lifestyle, and prescription needs.
Which is superior?
Both Medigap and Medicare Advantage has benefits and drawbacks.
Medicare Advantage has benefits that include :
• More benefits and coverage, including long-term care, gym memberships, and disability equipment
• Reduced premiums
• A package deal that includes Medicare Parts A, B, and D
Medicare Advantage has a number of drawbacks, including:
• You must confirm that your plan covers your desired provider.
• No coverage while traveling
• A potential increase in unforeseen expenses and emergency charges
The following are some benefits of Medigap plans:
• Less out-of-pocket costs
• Access to every Medicare-accepting provider.
• Coverage when visiting another country.
The following are a few drawbacks of Medigap plans:
• Increased monthly premiums
• Have to traverse the various plan kinds
• No prescription drug insurance (which you can purchase through Plan D)
Medigap policies don’t cover everything
Medigap policies are supplemental insurance that pays out in addition to Medicare, which means they can only cover copayments and coinsurance. Therefore, it is important to understand what exactly Medigap insurance covers and what it doesn’t to avoid unwanted surprises.
Typically, Medigap policies do not cover:
• Continuing care (like non-skilled care you get in a nursing home)
• Dental or vision care
• Private-duty nursing
• Hearing aids
• EyeglassesIn conclusion, it is often beneficial to have a Medigap policy, but not always necessary. Before you file for Medicare, it’s important that you understand your need and how Medigap might help. There are many factors to consider before deciding if Medicare supplemental insurance is right for you. You can learn more about Medicare Supplement coverage by visiting this page. These include your medical history, income level, and current health care coverage. It’s important to discuss your specific situation with an insurance professional when considering this type of coverage to come up with the best plan for yourself.