Understanding Medigap: Medicare’s Supplement Insurance Plan

Submitted by: John Coli

Medicare Supplement Insurance -Medigap- is a private health insurance policy that is designed to supplement Original Medicare (Part A and Part B). Medigap is provided by private health insurance companies but run by Medicare. Medigap helps pay some of the health care costs that Original Medicare does not cover (“gaps” such as copayments, coinsurance and deductibles) as well as certain services that Medicare doesn’t cover at all. If you have Original Medicare and a Medigap Policy, Medicare pays its share of the Medicare approved amounts for covered health care costs, followed by your Medigap policy’s payment.

Every Medigap policy must follow both federal and state laws. Medigap policies are standardized and identified by letters A-L. Each policy must offer the same basic benefits no matter which health insurance carrier sells it, the only difference will be the price each carrier offers.

Policy A offers the basic and core benefits while the other eleven policies contain the basic benefits as well as a few additional benefits. Plan A offers the following benefits:

Part A Hospital Coinsurance for Days 61-90

Part A Hospital Lifetime Reserve Coinsurance for Days 91-150

365 Lifetime Hospital days beyond Medicare coverage

Part B 20% Coinsurance

Part A and Part B 3 pint blood deducible

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The remaining policies (B through L) offer a different combination of the following benefits:

Part A Skilled Nursing Facility Coinsurance for days 21-100

Part A hospital deductible

Part B deductible

Foreign Travel Emergency coverage

At Home Recovery

Preventive medical care

When you buy a Medigap policy, you must have Medicare Part A and Medicare Part B. You will have to pay a premium for both Medicare Part B and your Medigap policy.

However, be advised that many benefits are not covered under any Medigap, including:

Dental Care

Hearing Aids

Prescription drug costs that exceed $3,000 per year

Private duty nursing

Skilled Nursing care after 100 days

Vision Care

Please note that Plans E, H, I and J are no longer sold (as of 2012). But if you already have one, you are allowed to continue receiving benefits.

Lastly, the Medicare insurance experts at MedicareSolutions are available to help you find a Medigap Plan that meets your needs. Please visit http://www.medicaresolutions.com/medigap.asp for a user-friendly resource that highlights each Medigap Plan available to you. Click on a specific plan and you will be able to read more on what benefits that plan offers.

Medicare Solutions is a service of Health Plan One, LLC and offers Medicare supplement and Medicare Advantage plans from most of the top, national insurance companies. We strive to put the customer in the highest quality product that best fits their financial and health care needs. And so, in determining the right products to offer consumers, we have selected companies that have strong and trusted brand names, A financial ratings, and very competitively priced products. Please view our sites or call our toll free number for more information on Medigap Plans.

If you’d like to learn more, compare plans or purchase health coverage then visit http://www.medicaresolutions.com or call one of our licensed health insurance agents at 800-328-7305.

About the Author: Questions? Email John at JColihan@healthplanone.com

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