If you have Medicare, are your insurance needs covered, or do you need a Medicare Supplemental Insurance (Medigap) policy?
The answer to that question may surprise you. As we’ll learn today, Medicare doesn’t cover everything, and so it’s actually a very good idea to look into a Medicare Supplemental Insurance, or Medigap, policy.
What is Medicare Supplemental Insurance (Medigap)?
Medicare Supplemental Insurance plans, also referred to as Medigap plans, are designed to help cover the gaps in coverage left over after Medicare has paid its share.
That’s right: in case you weren’t aware, Medicare will not cover all of your health insurance costs. Medicare will pay for whatever it will pay for, and then you’re on your own – unless you have a Medigap plan, or some other form of insurance.
Medigap policies are different from Medicare because they are sold by private companies, although they have a very important protection: your Medigap insurer cannot cancel your policy if you get sick.
They’re also different from Medicare Advantage, which is Medicare with additional benefits – specifically, they’re designed to be more flexible.
With this in mind, let’s take a look at what Medigap plans cover.
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What Does a Medigap Plan Cover?
There are a total of 10 different types of Medigap plans available across most parts of the country, and the benefits they offer vary from plan to plan.
In general, as with other types of insurance plans, you’ll have to choose between paying higher premiums now for better coverage if you need it later, or else paying lower premiums now and then having less coverage later.
If you want complete coverage of everything after your Medicare plan, your best choice is a Medigap F plan – but you will of course be paying higher premiums.
All plans cover remaining costs for Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up. It gets a little more variable after that: skilled nursing facility care coinsurance is covered by Plans C, D, F, and G, as well as M and N, covered 50% by K, 75% by L, and not at all by A or B.
For another example, the Part B deductible is covered by C and F plans but not by any of the other plans.
It’s a good idea to consider what you’ll need as well as your budget before deciding on a Medigap plan. All plans offer some good benefits, but different people will need to make different tradeoffs.
Who Can Buy a Medigap Plan?
If you have Medicare Part A and Part B, you can sign up for a Medigap policy. You will have to pay an additional premium – because this is not Medicare (and Medicare is not free in any case), you will have to pay a premium to your Medigap insurer. Depending on your stage of life, loss of recent coverage, or other factors, you may need to fill out a medical questionnaire to see if you qualify.
Also, be advised that you have to choose between Medigap and Medicare Advantage.
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The right Medigap plan can help you achieve peace of mind and security for your health. Hopefully the information presented here will be helpful to your decision regarding whether an Oregon Medigap plan will be right for you.