Medicare plans offer comprehensive health insurance coverage and individuals have to choose between an Original Medicare or a Medicare Advantage plan. However, Individuals need to understand that Medicare doesn’t pay for everything, as they are responsible to pay a certain percentage of their medical bills along with out-of-pocket expenses. At times it is not possible for everyone to pay those bills from their pocket, so to help individuals pay those bills, Medigap or Medicare supplemental plans were designed. Medigap plans work along with Original Medicare and these plans can be availed through private insurance companies or brokers, as these plans are not available on Medicare.gov.
Medigap is not health insurance but it helps enrollees pay for healthcare costs that are not covered by Original Medicare like copayments, deductibles, and healthcare if they travel outside the U.S. These plans are only available to individuals already having Original Medicare that covers hospital and doctor services. Individuals having a Medicare Advantage plan cannot get a Medigap plan. There are ten standard Medigap plans available labeled A through N offering different levels of health coverage. Though plans E, H, I, and J are no longer available to new members. The premium cost of the Medigap plans varies among insurance companies, though the benefits offered by each standard Medigap plans are always the same.
Cost of Medigap Plans
Calculating the cost of Medigap plans is not easy, as health insurer base Medigap’s monthly premiums by age. Some plans do not consider age while other plans do consider the age and increase premium rates as one’s age. High deductible Medigap plans cost less than $100 while others like Medigap A, B, and C plan cost more than $300 a month. Just like any other plan, it is best to shop around while looking to buy Medigap plans. Thus, individuals should first figure out the plans that are best for them and then should obtain quotes from multiple insurers offering Medigap plans. People paying more for Medigap plans will get more out-of-pocket costs coverage.
Types of Medigap Plans
Ten standardized Medigap plans are authorized by the federal government. Though, not all the plans are available in each area so individuals need to check the Medigap plans available in their area. The ten standardized Medigap plans are referred by letters A, B, C, D, F, G, K, L, M, and N. Each Medigap plan of the same letter has the same set of benefits irrespective of the insurance company selling it. The benefits under each Medigap plan are standard but the costs are not. The cost of the Medigap plan varies from company to company. Individuals need to find a Medigap plan that is best for their age, health, and financial situation, and they should review their choices every year during the open enrollment. Individuals who wish to keep the same supplemental plans don’t have to do anything. However, the insurer is required to notify individuals about any change in coverage and prices that will become effective from January 1, and individuals need to review their choice to ensure that the plan is still best for them. Individuals should also make sure that the medications taken by them are still covered under their plan and also their doctors and hospitals are still part of their program.
Time to Buy a Medigap Plan
Individuals can buy a Medigap plan during the annual open enrollment period or when they turn 65 years of age. The open enrollment period is six months’ period that starts from the first day of the month of individual’s 65th birthday, as long as they are signed up for Medicare Part B or within six months of signing up for Medicare Part B. However, individuals can buy a health plan outside of the open enrollment period, but there is no surety that individual will get the policy at that time. They may need to meet medical underwriting requirements. Most of the states require health insurance companies to offer at least one Medigap plan to non-elderly people having the end-stage renal disease. The insurer can delay the Medigap coverage due to pre-existing conditions in individuals if they buy a plan outside of the open enrollment period.