What is a Medigap plan and why you may want one?
Medigap plans (also called Medicare Supplement plans), are sold by private companies. They pay for some of the healthcare costs that Original Medicare doesn’t cover – including copayments, coinsurance and deductibles.
In addition, and for higher premium costs, some Medigap plans offer coverage for services that Original Medicare doesn’t cover, like medical care outside the U.S.
Quick Review: What’s the Difference Between Medigap Policy and Medicare Advantage?
A Medigap plan supplements the original benefits you receive from Medicare. It contributes to the payments that Original Medicare makes for your healthcare expenses. If you have both a Medigap and Original Medicare, Medicare will pay its share and then your Medigap plan will pick up from there.
Remember, these plans are different from Medicare Advantage Plans, which offer an alternative way to receive your Medicare insurance. Medicare Advantage plans usually bundle a wide variety of healthcare coverages into one plan (ie: prescription drugs, vision, dental etc). When you enroll in Medicare Advantage you opt to receive your Medicare directly from the insurance company and not from Original Medicare.
To summarize . . . Medigap (also called Medicare Supplement) pays for expenses that Original Medicare doesn’t. Medicare Advantage is different. It offers an alternative way to receive your Medicare healthcare insurance.
Medigap Gives You the Important Advantage of Guaranteed Issue
The Guaranteed Issue period for Medigap plans is another reason you should strongly consider this Medicare option.
Guaranteed issue is a very important topic when it comes to the Medicare Supplement plans or Medigap. It means that by law, the insurance company that issues the policy must offer you coverage without asking you about any preexisting medical conditions if you enroll during the first 6-months after signing up for part B. Furthermore, that company cannot cancel your policy as long as you continue to pay your monthly premiums. Even though enrolling in a Medigap policy will require you to pay monthly premiums, there are considerable benefits for doing so.
To enroll, be certain that you sign up during your initial six-month enrollment period which begins the first day you enroll in Medicare Part B. If you fail to do that, your options are limited. You can still sign up for a Medicare Advantage plan, or be subject to underwriting for a Medicare Supplement plan, which depending on your health can be more expensive or may exclude you from Supplemental coverage. If you think you want a Medigap policy the best time to get one is during your Guaranteed Issue period.
Shop Around for the Lowest Cost Medigap Plans
Remember, all Medigap plans are federally regulated, so the coverage they offer is about 99% the same. However pricing can vary according to the geographical area where you reside, so be sure to shop around. Note: CoverRight does all the leg work for you and will show you all the plans in your area and the associated costs.
Which Medicare Supplement Plan Should You Consider? Plan G, Plan N, or one of the others?
Neither Plan G nor Plan N covers your Part B deductible, which is $233 in 2022. But once you have met that deductible for the year, your plan will pay the rest.
Both Plan G and Plan N policies cover many of the costs that Original Medicare doesn’t. For instance, they will cover:
- Blood (first 3 pints you receive)
- Foreign travel emergency care (may vary by policy)
- Medicare Part A coinsurance and hospital costs
- Medicare Part B coinsurance
- Part A hospice care coinsurance or copayment
- Skilled nursing facility coinsurance
- Your Medicare Part A deductible ($1,556 in 2022)
Note that Supplement Plan G policies cost more and provide more extensive coverage than Plan N policies do. Plan N policies will not cover certain add-on charges that health care providers can add to your bill.
In addition, Plan N policies do not cover copays for office visits. So read the fine print. You could learn, for example, that your Plan N policy will only pay for your emergency room visit if you are admitted as an inpatient; if you are not, you could be hit with a hefty bill for your visit.
The bottom line is, to learn everything you can about your policy type before you enroll, and get some expert guidance.
And Make Sure You add a Medicare Drug Plan (Part D) to Your Medigap Coverage
In addition to your Medigap plan, you must enroll in a drug plan, Medicare Part D to cover your prescription drugs (you need a plan even if you don’t take any medications.)
Talk with a qualified and licensed Medicare counselor at CoverRight to help you find the best Part D plan to meet your needs! If you do not get the drug coverage you need during your initial enrollment in a Medigap/Medicare Supplement policy, adding it later will result in penalties and a potential gap in coverage.
Ask the right questions and get the right advice early in your decision-making process. If you get the right policy the first time you enroll, you stand a much better chance of being a happy Medicare recipient who sets everything up correctly on the first try and then goes on to have the right coverage, economically priced, in the months and years ahead.
CoverRight is on a mission to make the Medicare plan selection process easy to understand and help you find the best Medicare plans suited to your specific situation. Try our self-guided quiz to see for yourself….
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