Helping seniors navigate the confusing maze of options available

If you have recently reached the age of 65, you may welcome the fact that you are now eligible for Medicare. For many seniors, this federal health insurance program offers much-needed financial relief from medical bills. It is important to know that, although Medicare does cover a substantial portion of health care expenses, it does not cover everything. Beneficiaries often find that they still need assistance with many Medicare expenses. To cover those expenses, millions of Americans purchase Medicare Supplement Insurance, known as Medigap.

 

What exactly is Medigap?

Medicare Supplement Insurance - also known as Medigap - is an insurance policy sold by private companies. Medigap plans are formulated to fill in the gaps in Medicare coverage to limit the out-of-pocket expenses for enrollees. Many Medicare beneficiaries purchase Medigap to help cover the cost of insurance copayments, deductibles, and medical expenses that are incurred during travel outside of the United States and its territories.

If an individual has Medicare and purchases a Medigap policy, Medicare will pay the Medicare-approved amount for covered health care costs and then the Medigap policy pays its share. It is important to note that Medigap policies generally do not cover vision care, dental care, long-term care, eyeglasses, hearing aids, or private-duty nursing.

 

Medigap policies

• Only individuals who already have Medicare Part A and Medicare Part B can purchase a Medigap policy.
• Individuals who have a Medicare Advantage plan can apply for a Medigap plan but must leave the Medicare Advantage Plan before the Medigap policy begins.
• Medigap policies only cover one individual. Spouses seeking Medigap coverage must purchase two separate policies.
• Medigap policies can be purchased from any insurance company that is licensed in your state to sell such a policy.
• Medigap policies require a monthly premium to be paid to the private insurance company issuing the policy in addition to the monthly Part B premium that is paid to Medicare.
• All standardized Medigap policies are guaranteed renewable. This means that, even if you have health problems, the Medigap insurance company cannot cancel your policy provided you pay the premium.

 

Where can I purchase a Medigap policy?

Private health insurance carriers in every state offer Medigap policies. These insurance companies must abide by state and federal laws. If you have a Medicare Medical Savings Account (MSA) it is illegal for anyone to sell you a Medigap policy.

Medigap carriers in most states must offer standardized policies. These policies are identified by the letters "A" through "N", with a total of ten different plan designs. Within each letter, the plan benefits are the same from one state to another and from one carrier to another. The cost of a specific Medigap policy varies depending upon the type of plan, the insurance company, the location in which it was purchased, and the beneficiary's age.