Medigap Insurance

Medigap plans are a type of Medicare supplemental insurance offered by private health insurance companies. It helps pay the costs (such as deductibles and co-payments) and medical situations that are not covered by the original Medicare plan.

The original Medicare program (Medicare Part A and Medicare Part B) does not cover:

Prescription Drugs
Extended Hospital Stays
Specialized In-Home Care
Co-payments and Deductibles
Medical Travel Expenses

A Medicare insurance supplement can cover these gaps in insurance.

Medigap Verses Medicare Advantage Plans

Medicare Advantage Plans (also known as Medicare Part C) are cheaper Medicare supplement solutions if you are solely looking to receive extended coverage for the medical situations listed above. However, Medicare Advantage Plans seldom provide coverage for the high cost of co-payments and deductibles.

The deductible protection and co-payment protection is why most people choose a Medigap insurance policy. Extended coverage for medical situations is great but if you think you may have problems paying for the high cost of deductibles and co-payments then you should strongly consider a Medicare Insurance Supplement.

Medicare Insurance Supplements allow you to receive many of the extended medical situations that a Medicare Advantage Plan provides as well as providing help with co-payments and deductibles.

Medigap Policies

There are 12 standard policies categorized A thru L. Plans K,L,F &J are the plans you should focus on if you are concerned with limiting your out of pocket cost and deductibles.

Plans K-L are newer plans that limit your out of pocket expenses. For 2008, K and L’s out of pocket limits are $4,440 and $2,220. K-L will have a lower premium than many of the other policies but you will pay a larger deductible before the policy pays for medical cost.

Plans F-L usually cost less but have a high deductible. The 2008 deductible limit for F and L is $1,900.

Medicare select plans exist in some states. They are structured to be compatible with plans A-L. These plans also offer cheaper monthly premiums but you must use doctors that are on the approved listing.

Important Considerations

Only one person is covered per policy. If you and your spouse both need coverage then you must purchase two separate policies.

Long-term care, vision and dental, eyeglasses, private nursing care, and hearing aids are not covered.

You cannot have a Medicare Advantage Plan and a Medigap policy.

You must have Medicare Part A and Part B. You will continue to pay your monthly Part B premium. You will then have to pay a premium to the insurance company that is providing the Medicare insurance supplement.

Eligibility

Open enrollments last for six months after you turn the age of 65 (You must also already be enrolled in Part B).

During this period insurance companies can’t refuse to sell you any Medicare supplemental insurance policy that it sells, delay your coverage start date (unless you have a pre-existing condition), or deny you a policy for any health related issues.

If considering a Medicare supplemental insurance product then we strongly recommend registering during this open enrollment period. If you apply for coverage outside of the open enrollment period, there is no guarantee that you will be accepted.

You may also have to pay a late enrollment penalty which will create a higher monthly premium for you.

There are many other Medicare Supplemental Insurance options available. Be sure to take a look at our Medicare supplemental insurance page for a full review on these other options.

There are also a number of other Medigap resources if you would like to learn more about these policies.

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