Medigap insurance

Medicare is an insurance policy to provide you with peace of mind in your latter years. The last thing you want to worry about when you face an illness or repeated health care visits is the cost of care and your dwindling savings’ accounts. Although Medicare pays for most health related services it does not, unfortunately, pay for them all. This is why we have Medicare Supplement Insurance, otherwise known as Medigap. The costs of copayments, coinsurances and deductibles can eat into your savings even if you have Medicare insurance and this can leave you with a heavy financial burden. These other out-of-pocket expenses can add up to a substantial amount if you are hospitalized or require specialised nursing home services. Therefore it is essential that you consider Medigap Insurance.

Medigap policies must be clearly identified as Medicare Supplement Insurance and the policies are sold by private insurance companies. The policies must follow Federal and state laws and are specifically designed to protect consumers. No matter where and from whom you purchase Medigap, they must offer the same basic benefits. This is regardless of your location and the insurance company you choose to purchase this insurance from.

The cost of Medigap will vary depending on which policy you pick. They have a total of 12 different types of policy that will provide insurance protection for you. The plans are labelled from A-L, with A offering the lowest premiums and the fewest benefits. The opposite can be said for plans at the other end of the scale. The Medical Rights Centre has confirmed that the 2 most popular Medigap policies are C and F. The basic benefits that all Medigap policies from A to J provide are:

  • Inpatient Hospital Care – This will cover Medicare part A coinsurance and will also provide coverage for an additional 365 days once your Medicare coverage expires.
  • Medical Costs – This covers Medicare Part B coinsurance, as well as copayments for any hospital outpatient services. You will find that the Part B coinsurance is typically 20% of the approved Medicare amount.
  • Blood – Medigap will cover the first 3 pints of blood that you may require each year.

It very much depend on which Medigap plan you choose, however you can get coverage for certain benefits and expenses that Medicare does not cover, including:

  • Hospital Annual Deductible
  • Emergency Care During Foreign Travel
  • Skilled Nursing Facility Coinsurance
  • At Home Recovery Plan
  • Preventative Care that is not provided by Medicare
  • Part B Annual Deductible

It is important that you compare Medigap policies once you have determined what your medical needs might be and whether you envisage a shortfall in coverage. Insurance companies cannot sell you more than one Medigap policy under state and Federal law, so it is of the utmost importance to get it right first time. You may actually find that Medigap is not for you and therefore may wish to investigate the alternatives. These may include Medicare Savings Programs that are intended to help people who have limited resources and income. Perhaps Medicaid may be a more suitable option – this is a program that provides help insurance for the retired as well as assistance with prescription drugs.

There are certain elements of health care that Medigap will not cover you for. There are namely hearing aids, dental and vision benefits. They will also not cover for providers of long term care services, such as a private nurse to bathe, dress and feed you. In order to be eligible for Medigap you must enrol within the first 6 months after turning 65 or after enrolling in Medicare. If you wish to join outside these enrolment periods, you may be required to obtain a physician’s statement or undergo medical screening.

Medigap policies offer standardized health insurance “gap” coverage across the United States. However, Massachusetts, Minnesota and Wisconsin are an exception to these rules. This means that should decide to move or travel around the USA, you will not be penalized for not having adequate Medigap insurance. Therefore there is no need to worry about having to understand the differences in policy details from state to state. As an additional benefit (at a higher premium) you can also choose to cover some emergency health care costs whilst travelling outside the United States.

Last updated on Jun 25th, 2010 and filed under Health Insurance. Both comments and pings are currently closed.

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