Medigap is a Medicare supplement insurance sold by private companies. It can be of great help in paying for some of the health care costs that the original Medicare does not cover such as coinsurance, copayments, and deductibles. There are also some Medigap policies that cover for services that is not included in the original Medicare like medical care when traveling to other countries.
If, as of this moment, you have the original Medicare but you want to buy a Medigap policy, then Medicare will pay its own share of the Medicare-approved amount for the covered health care costs. Then the Medigap policy will pay its share.
However, it is important to note that a Medigap policy is different from a Medicare Advantage Plan. Those kinds of plans are a way to avail of Medicare benefits. On the other hand, Medigap policy supplements the original Medicare benefits.
Medigap Policies: The Things you should know
- You need to have Medicare Part A and B.
- If you currently have a Medicare Advantage Plan, you may apply for a Medigap policy. You just have to make sure that you can leave you Medicare Advantage Plan before the Medigap policy begins.
- On a monthly basis, you will be paying the private insurance company for the premium for your Medigap policy. This is in addition to the monthly premium that you are paying to Medicare.
- A Medigap policy is limited only to one person. Thus, if you and your wife want to have Medigap coverage, you both have to buy separate policies.
- You may buy a Medigap policy from any insurance company in your State that is licensed to sell one.
- A standardized Medigap policy is renewable even if you have health problems. In other words, the insurance company will not cancel your Medigap policy, given that you are paying the premium.
- In the past, some Medigap policies sold cover prescription drugs, but Medigap policies sold after January 1, 2006 aren’t allowed to include prescription drug coverage. So if you want prescription drugs to be included in your coverage, join a Medicare Prescription Drug Plan (Part D).
- It is illegal for anyone to sell you a Medigap policy if you have a Medicare Medical Savings Account (MSA) Plan.
Medigap Policies do not cover everything
Medigap policies generally do not cover vision or dental care, long-term care, eyeglasses, hearing aids, or private-duty nursing.
The following are insurance plans that are not Medigap:
- Medicare Prescription Drug Plans
- Veterans’ benefits
- Long-term care insurance policies
- Medicare Advantage Plans (like an HMO, PPO, or Private Fee-for-Service Plan)
- Indian Health Service, Tribal, and Urban Indian Health plans
Do you need one?
A Medigap policy supplements your original Medicare coverage. It will be paying for the expenses that the original Medicare doesn’t cover. It can give you more freedom of choice than Medicare Advantage and is a better option for snowbirds and others who travel a great deal or live in different places from time to time.