Making Sense of Medigap Insurance and How it Works

As people age, health concerns tend to increase – that’s why healthcare is considered a crucial aspect of life for seniors. Consequently, people above the age of 65 years can enroll in the Medicare Health Plan to get access to various important healthcare amenities. However, Medicare does not cover all medical expenses that seniors face, such as deductibles, copayments, and coinsurance. This is where Medicare Supplement Plans come in handy. In this article, we will discuss everything you need to know about Medicare Supplement Plans, including what they are, how they work, how to enroll, and how they differ from other Medicare coverage options.

What are Medicare Supplement Plans?

Medicare Supplement Plans, also known as Medigap policies, are health insurance plans that are designed to fill the gaps in the standard Medicare policy’s coverage. Several private insurance companies offer these plans, although the benefits offered are standard across all policies. There are ten Medicare Supplement Plans available, each labeled by a letter, ranging from Plan A to Plan N. The benefits offered differ from plan to plan, with each furnishing varying degrees of doctor visits, outpatient care coverage, deductibles, and coinsurance.

How do they work?

Medicare Supplement Plans are designed to work alongside Original Medicare. This means that when you visit a healthcare facility, your Medicare policy pays for its portion of the bill first. After that, your Medigap policy pays its portion of the bill. Therefore, having a Medicare Supplement Plan ensures that you have little to no out-of-pocket expenses. Depending on the plan you choose, your out-of-pocket expenses may include monthly premiums, prescription costs, and other miscellaneous charges.

How to Enroll in a Medicare Supplement Plan

The ideal time to enroll in a Medicare Supplement Plan is during the open enrollment period, which is a six months window period that begins from the month you turn 65 years old and are enrolled in part B of the Medicare policy. During this period, you have guaranteed issue rights, and insurance companies cannot deny coverage, charge you a higher premium, or delay your coverage for medical issues such as pre-existing conditions. If you opt to enroll in a Medigap policy outside of this period, the insurance company may request you to go through medical underwriting, which can lead to a higher premium or even denials of coverage.

How do Medicare Supplement Plans differ from other Medicare Coverage options?

Medicare Advantage plans are another coverage option under Medicare. These are Medicare-approved health insurance policies offered by private insurance companies. However, unlike Medigap policies that work alongside Original Medicare, Medicare Advantage plans are designed to replace Original Medicare entirely. Therefore, you cannot have both Medicare Advantage and Medigap policies at the same time. Another difference between the two is that Medicare Advantage policies offer additional coverage such as vision, dental, and prescription drug services. This is not a benefit of Medicare Supplement Plans.

In conclusion, Medicare Supplement Plans are designed to work alongside Original Medicare and with the aim to provide seniors with better healthcare coverage. They fill in the gaps in the standard Medicare policy and ensure that seniors have little to no out-of-pocket expenses. The benefits offered differ from plan to plan, with each furnishing varying degrees of doctor visits, outpatient care coverage, deductibles, and coinsurance. You can enroll in a Medicare Supplement Plan during the open enrollment period, which lasts six months from the month you turn 65 years and are enrolled in part B of the Medicare policy. When considering which plan to choose, it is crucial to understand the factors that differentiate Medicare Supplement Plans from other Medicare coverage options such as Medicare Advantage.