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Everything you need to know about Medigap

Medicare Supplement (Medigap) policies are offered by private companies to help pay expenses not covered by Original Medicare, Part A and Part B. These expenses include copayments, coinsurance, and deductibles. Medigap plans are no longer allowed to pay the Part B deductible or include Part D prescription drug coverage. You can buy a Part D policy for prescription coverage. You cannot have both a Medicare Supplement policy and a Medicare Advantage plan.

Medigap policies are for individuals, so you and your spouse need separate policies. Medigap policies are guaranteed renewable, so long as you pay the monthly premium, they cannot cancel your coverage, even if you have health problems. You will pay costs associated with the Medigap policy in addition to your Part B premium.

Some Medigap policies also cover services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, here’s what happens:

  •  Firstly, Medicare will pay its share of the Medicare-Approved Amount for covered health care costs.
  •  Then, your Medigap insurance company pays its share.

The Medigap Plans

Medigap has 10 plans named alphabetically (A, B, C, D, F, G, K, L, M, and N). Each plan was standardized by Medicare in 1990. Plans of the same letter differ only in their monthly premium assigned by the private insurance company. Plans F, G, and N are more common.

Plan F pays 100% of the costs remaining after Medicare pays its share. With Medicare Supplement Plan F, you pay no deductible or copay.

Plan G pays everything except the Part B deductible. Plans often save people as much as the cost of this deductible.

Plan N has lower premiums than F or G but pays for less. You pay a $20 copay for doctor visits and $50 for E.R. visits. You also pay the Excess Charges, which are charges the medical provider bills in excess of the Medicare-approved amount.

What Medigap Does Not Cover

Medigap plans do not cover anything beyond Original Medicare Part A and Part B expenses.

Medicare does not cover routine dental, vision, or hearing exams. It does not cover hearing aids, dentures, glasses, or contacts. Medicare does not cover long-term care or retail prescription drugs.

Doctor presenting Medigap policies

How Do I Pick Medicare Supplement plan?

With a Medicare Supplement, you can lower what you will pay with Medicare Part A and Part B. Medicare Supplements, also known as Medigap, are health insurance plans provided by private companies to help provide coverage for health services not covered by Original Medicare.

Medicare Supplements don’t have networks of hospitals, doctors, or make any decisions about what to cover. Instead, all they do is help pay for a specified share of medical costs not covered by Medicare. If you have decided to purchase a Medicare Supplement plan, you need to know how to pick the right option.

What Are the Medicare Supplement Plans Available in your Area?

All Medigap plans are standardized – this means they provide the same coverage irrespective of the private insurance company you choose. However, these insurers can decide which Medigap plans they want to provide and in what area. For instance, the insurance company might decide to cover Medigap Plan A, N, and G, but in four states.

That is why it is a good idea to do a comprehensive comparison shopping. To make things easy, you can contact experienced Medicare experts, such as Turning 65 Solutions, to help you narrow down your options and give you a better idea of which Medigap plans are available in your area.

Understand All the Medicare Supplement Plans

Each Medigap plan covers a different aspect of healthcare. While all the plans cover 100% of your Part A hospital costs and coinsurance, every other class is different. For a start, Plan F is the most comprehensive Medicare Supplement plan as it covers nearly all out-of-pocket costs. However, this plan is no longer available to Medicare beneficiaries who became eligible in 2020.

So, for new enrollees, Plan G is the most comprehensive and offers more value. It is similar to Plan F only that it doesn’t cover the Part B deductible. Other Medigap plans provide less coverage but cost less than Plans F and G.

Consider Your Needs and Budget

Once you are familiar with each plan’s coverage, you can figure out your health demands and budget. Remember that if you decide to change your plan later in the future, you might be subject to underwriting. So, it is better to choose a Medicare Supplement plan that will serve you well when you turn 65.

For instance, let’s assume that you never plan to travel abroad; purchasing coverage for foreign travel wouldn’t make sense in this case. You might also consider your overall health, chronic or pre-existing condition, and income. If you want to purchase a plan that allows you to budget your money effectively, a comprehensive Medigap plan like Plan G might serve you best.

Are Medicare Supplement Plans worth it?

With the help of Medicare, millions of people get access to the care they couldn’t afford. However, Medicare is not free; enrollees are responsible for out of pocket payments for coinsurance, deductibles, and premiums. For those living on limited or fixed incomes, the medical costs add up quickly.

The people who don’t understand out of pocket risks with Medicare Part A and Part B (Original Medicare) always ask themselves, “Are Medicare Supplement plans worth it?” The short answer is yes. Any Medical beneficiaries that want to protect themselves from receiving expensive medical bills should consider enrolling in a Medicare Supplement plan.

What Do Medicare Supplement Plans Cover?

Medicare Supplement, also known as Medigap, helps pay for the part that Medicare beneficiaries would be responsible for when they receive services from Medicare Part A and Part B. Generally, Original Medicare only pays for 80% of your medical costs, and you’re responsible for the remaining 20%. These figures can quickly add up, but with Medicare Supplement plans, you can fill the gaps left by Original Medicare. Medigap plans are available with different levels of coverage, so you can choose the one that meets your needs.

Should You Purchase a Medicare Supplement Plan?

You should consider a Medicare Supplement plan for two major reasons. First, no matter the precautions you take to keep yourself healthy, life does happen. Whether you catch the nasty flu, involved in some accident, or your physician recommends additional testing, you may incur medical bills when you least expect it. If, for instance, you are admitted to the hospital, the Part A deductible alone is $1,408, and you may need to pay this more than once a year.

Secondly, you may not be able to sign up for a Medicare Supplement when required. In most cases, Medicare beneficiaries that want to sign up for a Medigap plan after they have already been on Original Medicare for six months may have their application declined based on their health. Ultimately, you just can’t wait until you need a Medicare Supplement plan to get it.

Talk to a Turning 65 Solutions Agent

When it comes to choosing a Medigap plan, the decisions can be overwhelming. But it doesn’t have to be; the experienced Medicare agents of Turning 65 Solutions are here to help you choose a Medicare Supplement plan for your needs and budget.

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