FAQ Friday: What is Medigap Insurance?
Medigap Insurance, also known as a Medicare Supplement, is an insurance plan that will assist you in paying for some of costs that Medicare Parts A and B doesn’t pay. Original Medicare does not cover all of your medical costs, it will only pay 80% of your medical bills. You are required to cover the remaining 20% but there is no cap or max-out-of-pocket for that 20%. Without Medigap Insurance (Medicare Supplement) you are left fully exposed to that 20%.
The way that a Medicare Supplement Plan works is you would stay with Original Medicare and keep it as your primary coverage. This is how you keep your right to go to any doctor or any hospital in the country that accepts Medicare because there are no networks with these plans. Medicare is your network. You would continue to pay Medicare’s Part B premium ($135.50 for 2019). The Medicare Supplement would charge an additional premium; the premiums vary and are based on your age and zip code. They typically run from $80 to $150 depending on the plan and its coverage. In return, that Medigap plan (Medicare Supplement) will fill the holes in Medicare or fill in the gaps. It will pay the bills that Medicare doesn’t pay.
Example: you get a knee replacement and you have the Medicare Supplement Plan G. The only out of pocket expense with the Medicare Supplement Plan G is Medicare’s Part B annual deductible of $185. So, with Original Medicare and a Medicare Supplement Plan G, your knee replacement including all the physical therapy and treatments will only cost you $185 out of pocket. The remainder of the bills will be covered by Medicare and your Supplement plan.
Everyone has the opportunity to purchase a Medicare Supplement when they first turn 65 without having to medically qualify, it’s called the Open Enrollment Period. This Open Enrollment period starts 6 months before a person’s 65th birthday or Medicare Part B start date and ends 6 months after a person’s 65th birthday or Medicare Part B start date. After that period is over, everyone has to medically qualify to purchase a Medicare Supplement Plan.
The Medical Underwriting process is a fairly simple one. Each carrier is different but usually it consists of around 20 medical questions and there is no physical or lab work and needs to be done. There are around 30 different carriers that offer Medicare Supplements and they all have different guidelines for their Medical Underwriting. In general, most carriers want at least a two-year stable bill of health.
If you can afford the extra premium per month, you will love having a Medicare Supplement Plan. Medicare and a Medicare Supplement will provide you better healthcare than you have ever had in your life.
If you have any questions regarding Medicare, it’s coverage or plan options, please give our office a call at 1-855-368-4717 or visit one of our pages:
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