When you have the Original Medicare Plan coverage, you will find it does not provide 100% coverage. You will be required to pay deductibles, co-pays, and c…
When you have the Original Medicare Plan coverage, you will find it does not provide 100% coverage. You will be required to pay deductibles, co-pays, and co-insurance. While Medicare pays for a lot of health care services, there are still many it does not cover. Medigap Plans were designed to help pay the costs that Medicare does not cover.
A Medigap Plan is health care insurance provided by private insurance companies to cover the gaps in the Original Medicare Plan. Both plans will pay their shares of health care costs to your health care provider. Medigap policies must have specific benefits, and insurance companies are only allowed to sell modernized Medigap policies.
Medigap Eligibility Requirements
Medigap coverage only works in conjunction with Original Medicare . Typically, you must have Medicare Part A and Part B. If you and your spouse want Medigap coverage, you must each purchase separate policies. Medigap policies will only cover one person per policy.
Available Medigap Plans
Federal and state laws regulate Medigap policies. These laws are put in place to protect you as a beneficiary. Medigap policies have to be clearly labeled as “Medicare Supplement Insurance.” In most states, you may be able to choose from up to 11different modernized plans (Medigap Plans A through N).
Medicare plans offer a different set of benefits and is the same for every insurance company. Because benefits are the same for every insurance company, you do not want to overpay. Insurance companies set their own prices and decide which policies they want to sell.
If you’ve had Part B for longer than 12 months, you can get a yearly “wellness” visit to develop or update a personalized plan to prevent disease based on your current health and risk factors. This visit is covered once every 12 months.
If you received the “Welcome to Medicare” preventive visit, you have to wait 12 months before you can get your first yearly “wellness” visit. You don’t need to have a “Welcome to Medicare” visit before your yearly “wellness” visit.
You pay nothing for the yearly “wellness” visit if the doctor or other health care provider accepts assignment. If you get additional tests or services during the same visit that aren’t covered under these preventive benefits, you may have to pay, however if you purchase Medicare Supplements, it may pay for the additional services. There are a number of wellness services covered,please contact a medicare specialist.