So what is medicare supplemental insurance coverage? Quite simply, Medigap is privately sold insurance that fills the gaps between your Medicare benefits and the expenses that you would otherwise need to pay out-of-pocket. Policies can be purchased through private insurance carriers to cover the expenses that Medicare does not fully cover.
Medicare supplement insurance coverage includes benefits for deductibles and copays that you would normally be responsible for under standalone Original Medicare. Medigap coverage also gives you flexibility in selecting your own doctor. Once you’re covered, and as long as you’re paying your premium, you can never be removed from coverage due to health reasons.
Carriers of Medicare supplement plans provide 10 federally standardized insurance policies. Each standardized policy is labeled with a letter type, representing a different combination of benefits. Some of the benefits/gaps that Medigap covers include:
Hospital deductibles, copays and an extra 365 days in the hospital
The first 3 pints of blood as necessary in a transfusion
Outpatient deductibles, coinsurance and excess charges
Skilled Nursing coinsurance
Foreign travel emergency care
The prime opportunity to purchase Medigap coverage is anytime during your 6 month OEP (Open Enrollment Period). This period is unique to your age, automatically beginning the month you turn 65 and enrolled in Medicare Part B.
During your OEP, it’s important to note that you will typically receive lower pricing as well as more choices with the policies being offered. During this time you can enroll in your choice of any Medigap policy being sold in your state, whether or not you have any health issues.
After your OEP has been closed, there is a possibility that you may not be able to purchase a policy. And if you are able to purchase one, it may be more costly, as carriers now take into account your previous or current health problems. Don’t let this happen to you; take advantage of the lengthy time allotment provided to purchase your policy at a better price.
Are Medicare Supplement Plans Worth It?
You may be asking yourself…Do I really need a Medicare supplement plan? Let’s find out!
Understanding the Risk
Medicare Part A covers up to 60 days of hospitalization; and as of 2021, this comes with an associated deductible $1,408. Additionally, if you are still in the hospital after 60 days, you would begin paying a daily copay. If you are still receiving hospital care after 150 days, your hospital coverage becomes completely depleted.
Cost-sharing under Part B is comparable to Part A with some differences. You would be responsible for paying the Part B deductible, which is $198 as of 2021. Then your Part B Medicare would only cover 80% of approved services. This would leave you financially responsible for 20% of all your doctor visits, ER visits, blood tests, x-rays, surgeries, and other expensive health services.
Worst of all, there is no limit on that 20% either. You pay that as long as needed to cover the cost of the service. Can you imagine paying 20% of the cost of hip replacement surgery or another similarly expensive treatment? Is Medigap insurance worth it now?
What are medicare supplement insurance plans offering exactly? These policies can offer you peace of mind. As with any insurance, the most obvious benefit is knowing that if the unexpected happens, you’re protected. In the specific case of Medigap, you also won’t have to worry about your credit being tarnished or ruined; Medigap will cover medical bills of which you would normally be liable under standalone Medicare (Medicare can only cover to a capped limit).
Once your Medicare has paid its portion of your medical bill, your medicare supplemental health insurance will pay most of the cost remaining for Medicare-approved charges. Medicare supplements take care of items like co-payments, deductibles, and coinsurance; and some policies will even provide coverage if you are traveling outside of the United States.
Lastly, most Medigap supplemental policies are guaranteed renewable. This means that as long as you are paying your premium, you continue receiving coverage and cannot be denied or dropped due to your age or any health issues.
Both Medicare supplemental policies and Medicare Advantage can be great options depending on which works best for your specific situation. Knowing the key distinctions between these two options will help in making the right choice.
The main contrasts between Medigap policies and Medicare Advantage are their costs. For the most part, Medigap has a higher premium than that of Medicare Advantage. On the other hand, Medicare Advantage covers less services than Medigap, which can potentially result in higher out-of-pocket payments on your part. Depending on your exact needs, you can save money by selecting whichever policy makes the most sense to your lifestyle.
Selection of Doctor
Medicare Advantage provides a narrow choice of doctors within their network. Although some Medicare Advantage policies will offer out-of-network benefits, it comes at a higher cost. However, many will not cover out-of-network doctors, period. You’ll find that Medigap may provide more flexibility in that aspect.
Medicare Advantage typically offers coverage exclusively to one region or state. Most of the time, when traveling internationally, Medicare Advantage would not offer coverage. Medigap, on the other hand, provides coverage throughout the entirety of the United States, as opposed to only one region, while also offering coverage when traveling internationally. So if you would rather not limit yourself to a specific geographical area, then Medigap would be the more suitable selection.
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