Medicare has four parts: Part A, B, C, and D. Each part covers a different service.
Medigap supplements your coverage.
Medigap: What is it?
Medigap is also known as Medicare Supplemental Insurance. It is extra health insurance you buy from a private company that provides coverage for deductibles, co-pays, and services that are not covered by Medicare.
Why Do I Need It?
Medicare on average covers 48% of your medical expenses. You are responsible for the other 52%.
Medigap can help pay for premiums, deductibles, co-insurance, co-pays, and non-covered services you may need.
For Example: If Medicare Part B covers 80% of your doctor visits, your Medigap policy would pay the other 20%.
Many Medigap policies will pay for your deductible for Part A and Part B.
Essentially, Medigap fills the Gap or pays for expenses Medicare does not cover.
How Does It Work?
Claims are first submitted to Medicare Part A and Part B. Any unpaid portion is then submitted to your Medigap company, which will cover all or part of the remaining charges.
How Much Does It Cost?
There is a premium for Medigap. The average is about $150 per month. There are high deductible policies available at lower prices, but you must pay $2,200 in medical expenses before the policy pays anything.
What Is Covered?
Medigap can only be provided by Medicare-approved companies. The policies are standardized. There are 10 types of Medigap Plans. Each plan provides a different range of coverage.
Medigap plans are standardized and offer the same coverage nationwide. The coverage for Plan A in New York will be the same as the coverage for Plan A in Colorado. Though the coverage is the same, the price can vary widely. It is important to shop for the best price available in your area and make sure you are not paying more for the exact same coverage.
Not all insurance companies provide each of the different plans, but they must offer Plan A, C, and F if they offer any.
Massachusetts, Minnesota, and Wisconsin do not necessarily adhere to the standardized policies.
This 2017 chart is taken from the Medigap section of the Medicare website www.medicare.gov., and shows what each particular plan will cover.
Yes = the plan covers 100% of this benefit, No = the policy doesn’t cover it
% = the plan covers that percentage of this benefit. N/A = not applicable
The cost of a Medigap policy is about $150 per month. The initial cost of a policy may or may not be age dependent. Premiums may or may not be able to increase with time. Check your policy carefully.
Medigap does not cover your spouse. Each individual must have his/her own policy.
Should I Get It?
It would be advantageous for everyone to have a Medigap policy. The benefits will generally outweigh the costs over time. Your choice will depend on your financial situation—can you afford it? Do you have other coverage such as Veterans benefits? How is your overall health? Can you afford to be without it? It’s something you’ll need to decide.
What are your hopes for health for your future. What are you doing to stay healthy this year?
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