Top 5 Things You Need To Know When Looking For Medicare Supplemental ( Medigap) Plan

Medicare Supplement i.e. Medigap plans are sold by private insurers to compensate for the inadequate health coverage provided by Medicare Part A & B.

These policies cover medical procedures that are approved by Medicare at a Medicare Provider.  Here are the top five things that you must be aware of when buying Medigap plans:

  1. Medigap policies are only available to individuals who already have Medicare Part A for free hospital services and Medicare Part B for doctor services. Each plan covers one only individual, meaning you and your spouse will have to purchase separate Medigap policies.
  2. Medigap has 12 standard plans, through A to L, that offer different levels of health coverage and benefits.  Although different insurance companies sell these policies, they offer the same Medigap plan benefits. Not all Medigap policies may be available in your state.
  3. If you intend buy a Medigap plan, you must do it within the Medigap open six-month enrollment period that starts on the first day of the month in which you turn 65 and enroll in Medicare Part B.  During this period, insurance companies cannot use medical underwriting to deny you Medigap policy, or raise your premiums due to your health or apply waiting periods, unless you suffer from pre-existing medical conditions.  However, if you try to buy a Medigap policy after the six month enrollment period is over, there is no guarantee that you’ll be able to get coverage. In case you get covered, chances are that your rates may climb substantially.
  4. For a Medigap plan, you have to pay a monthly premium to the insurance company along with your Medicare Part B premium. The cost of the Medigap policy is determined as follows:
    1. Community-rated policies charge the same premium to everyone living in that area regardless of age.
    2. Premiums in Issue-age-rated policies are based on your age when you first bought the policy, however, the rate doesn’t increase automatically as you age.
    3. Attained-age-rated policies are inexpensive at the age of 65, but their rates increase automatically as you age.

    Generally, insurance companies establish their own prices and eligibility regulations, so it is recommended to shop around for the plan.

  5. Medigap plans cover some of your Medicare co-payments, co-insurance for hospital stays, and some other medical services such as preventive care, at home recovery, etc., thus reducing your out of pocket costs. It is important to note that Medigap plans do not cover eyeglasses, hearing aids, dental care, long term care etc. Prescription drug coverage can be obtained by enrolling into the Medicare Prescription Drug Plan, or Part D. You have to decide what type of plan is best for you. In most cases, if you give up your Medigap policy, you won’t be able to get it back.

Medicare Supplement Insurance has an automated claims process since it is linked to the Medicare B. Make sure that the insurance company has arranged with Medicare to file your Medigap claims automatically.

Once you are done with comparing the Medigap premiums and looked into the financial stability of the insurance companies, take your time to decide which type of Medicap plan can help you protect yours and your spouse’s health.

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