Is a Medigap Health Insurance policy right for you?
A Medigap policy is health insurance sold by private insurance companies to fill gaps in Original Medicare coverage. Medigap policies don’t work with any other type of health insurance. Medigap policies can help pay your share (coinsurance, copayments, or deductibles) of the costs of Medicare-covered services. Some Medigap policies cover certain costs not covered by Original Medicare. So let’s see what Medicare Coverages look like first.
Your Medicare Coverage Choices
With Medicare, you can choose how you get your health and prescription drug coverage. Below are brief descriptions of your coverage choices.
Original Medicare
- Run by the Federal government.
- Provides your Medicare Part A and Part B coverage.
- You can join a Medicare Prescription Drug Plan to add drug coverage.
- You can buy a Medigap (Medicare Supplement Insurance) policy (sold by private insurance companies) to help fill the gaps in Part A and Part B coverage (like coinsurance, copayments, and deductibles).
- NOTE: New Medigap policies can’t include prescription drug coverage.
Medicare Advantage Plans (like an HMO or PPO)
- Run by private insurance companies approved by Medicare.
- Provide your Medicare Part A and Part B coverage, but can charge different amounts for certain services. May offer extra coverage and prescription drug coverage for an extra cost. Costs for items and services vary by plan.
- If you want drug coverage, you must get it through your plan (in most cases).
- You don’t need a Medigap policy.
Medigap Policy Specifics
Every Medigap policy must follow Federal and state laws designed to protect you, and it must be clearly identified as “Medicare Supplement Insurance.” Medigap insurance companies can only sell you a “standardized” Medigap policy identified by letters A through L. Each standardized Medigap policy must offer the same basic benefits, no matter which insurance company sells it. Cost is usually the only difference between Medigap policies sold by different insurance companies.
You also need to know what Medigap policies do not cover. Medigap policies don’t cover long-term care (like care in a nursing home), vision or dental care, hearing aids, eyeglasses, and private-duty nursing.
Hopefully, this information has helped you understand your choices when it comes to Medigap. However, if you would still like more information, read more on the Medigap Health Insurance (Medicare Supplement Insurance) section of our website.
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Author: a www.ConcerningAging.com staff writer
Source: 2009 Choosing a Medigap Policy booklet by the Centers for Medicare & Medicaid Services (CMS) and the National Association of Insurance Commissioners (NAIC)