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Medigap Plans
Medigap plans are Medicare Supplemental Insurance policies designed to fill the 'gaps' within Medicare coverage. Original Medicare, including Part A Hospital Insurance and Part B Medical Insurance,pays for many health-related services and medical supplies, but a Medigap policy can cover items such as copayments, coinsurance, and deductibles, as well as expenses that Medicare does not cover, such as certain preventative medical expenses.
Medigap policies are voluntary and the policyholder is responsible for the premium cost. Medicare does not provide any assistance with paying a Medigap policy premium.
Medigap policies are sold by private insurance companies. These policies are required to be clearly identified as Medicare Supplement Insurance, and each policy must follow federal and state laws designed to protect consumers.
The Benefits
To allow consumers to compare policies and to standardize each policy to ensure full disclosure and truth in advertising, Medigap policies are identified by the letters A through N. Each letter offers a different set of basic and extra benefits within that policy. Note that Medigap plans E, H, I, and J are no longer be sold as of May 31, 2010, but policyholders who have those particular policies are permitted to keep them. Medigap plan M and N were new in 2010.
Typically, Medigap policies will cover charges that are not paid after Medicare pays their portion of a covered expense. Any expense not covered by Medicare or the Medigap policy is then the responsibility of the patient.
Medigap vs. Medicare Advantage Plans
Many just entering the Medicare system confuse Medigap and Medicare Advantage Plans, and it's an important distinction.
- Medicare Advantage Plans replace original Medical benefits
- Medigap policies supplement your Medicare benefits.
Despite advertisements and boastings to the contrary, each standardized Medigap policy must offer the same basic benefits, no matter which insurance company sells it. The only difference in the policies, as long as they have the same identifying letter (A through N), is the cost and insurance company offering the policy.
Medicare, as well as health insurance in general, is a complex system of rules and regulations that can be difficult to understand. It's important for seniors to make sure they grasp the terms that are used and understand their benefits. Representatives, whether they work for Medicare or a private insurance company that sells Medigap policies, are just a phone call away to answer specific questions you may have.
