All About Medigap Plans

There’s a Better Way to Handle Your Medicare Bills

One of the most confusing and frustrating aspects of healthcare is understanding the totality of benefits and how much you’ll need to pay out-of-pocket. In the case of Medicare coverage, there are extra expenses involved that are simply not fully covered and have to be paid out-of-pocket. This leaves you, the beneficiary, responsible for costly bills, which can be quite overwhelming to many Medicare holders.

 This led private insurance carriers to provide 10 standardized Medicare supplement riders as a solution to such an issue. These plans are widely known as Medicare health supplement plans, which help Medicare holders with their additional costs with the goal of minimizing out-of-pocket expenses. With Medigap plans, you become protected from all sorts of extra expenses by bridging the gap in your Original Medicare coverage (Part A & B)

Why waste your valuable time and energy worrying about managing your health care bills and complex expenses? Sign up for Medicare Supplement insurance coverage and spend your time enjoying retirement!  

What are Medicare Supplemental Policies? How do they differ?

Medicare Supplement insurance coverage plans are sold by insurance carriers. These plans are standardized, meaning they all must follow federal guidelines no matter who sells them or where they are sold.

While the 10 plans are different when it comes to co-pays, deductibles, etc… They all have the same requirements in common:

– Medicare policyholders cannot obtain Medicare supplemental plans unless they have Original Medicare (both parts A & B)

– There are no joint plans. It only covers one person. For example, a married couple will need two separate policies, one for each spouse.

– They are standardized; meaning they offer the same base benefits no matter where they’re sold. For example, Plan F sold in Texas offers the same benefits as Plan F sold in Georgia.

– While these plans are standardized, the Medicare supplement insurance cost varies from one carrier to another based on extra services offered.


Paying for your Medicare Supplement Coverage
If you are covered by Original Medicare (Medicare Part A & B) in conjunction with one of the Medicare supplement plan riders, you will end up paying two separate premiums. The first premium for Medicare Part B and the other for the Medigap insurance coverage; This is assuming you have no premiums to pay for Part A of Medicare, which you do not have to pay if you are 65 or older, and you or your spouse paid Medicare taxes for at least 10 years.

The premium for Medicare Part B is taken from your Social Security income check, but on the other hand, your Medigap premium has to be paid directly to the insurance carrier you purchased your policy from.

While Medigap insurance may cover some out-of-pocket expenses and bridge the gap in your Original Medicare coverage, both Original Medicare and Medigap do not outpatient prescription drugs. If prescription drug coverage is one of your main needs, you can purchase a separate Part D prescription drug coverage policy, which will leave you with a third premium to pay.


What does it cover?
Medigap coverage handles the sorts of expenses you, as a beneficiary of Original Medicare (Part A & B), would have to pay out-of-pocket. It is important to note that these expenses are covered by Medicare, but not fully covered.
In most cases, an insurance rider for Medicare handles out-of-pocket expenses for Medicare-approved services, which means non-approved services, such as vision and dental, are not covered.


What About Deductibles and Coinsurance?
Both parts of Original Medicare (A & B) come with coinsurance and deductibles. When the deductible is met, Part B covers 80% of the approved amount, which leaves you responsible for paying the remaining 20% with no limit on the out-of-pocket expenses.
For every benefit period, Medicare Part A applies a deductible, and then coinsurance starts to accrue after 60 days in the hospital. Although it is termed ‘coinsurance’, it is actually a fixed daily amount, not a percentage of the cost.
If you stay beyond 20 days in a skilled nursing facility, a coinsurance charged is applied as per Medicare Part A. As in the case of Part B, there is no limit on the amount you could spend in out-of-pocket expenses under Part A. This is when Medigap add on insurance for Medicare comes in to protect you from paying these deductibles and coinsurance expenses.

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