What is a Medigap Policy?
Medicare Supplement plans are a type of health insurance for people who have Medicare. They cover the gaps in Medicare under Parts A & B that you are responsible for and are known as Medigap plans. Medigap plans are secondary to Medicare and pay after Medicare pays its share of your medical expenses.
What are my Medigap choice?
Medigap plans are standardized, each plan is identified by a letter and while there are Plans from A – N, many of them are no longer available. Each company that offers a particular plan must provide the same set of benefits. So, the only difference is the price of the plan, and you can shop multiple carriers for the best rates available at the time you are looking.
Currently the most popular Medigap plans are Plans F, G and N.
Plan F covers everything that Medicare would normally charge to you, including all deductibles and co-pays. Plan F is no longer available to people who turn 65 after January 1, 2020.
Plan G covers everything that Medicare would normally charge to you, like Plan F, except the Part B deductible which is $226 for 2023 and changes from year to year as Medicare adjusts its costs. This is the most comprehensive and popular plan available today.
Plan N is like Plan G and has lower premiums than Plan G, but you have additional cost sharing. In addition to the Part B deductible, you will pay a $20 copay for doctor visits and a copay of $50 for an emergency room visit. You are also responsible for up to 15% excess charges which some doctors bill above Medicare rates.
How does your Medigap plan pay for your claims?
When you receive services that are covered by Original Medicare, they will first pay their share of the approved amount for services and then they will send a claim to your Medigap plan to pay their share. This is done automatically without any action on your part, and you should allow the claim to be processed by both Medicare and your Medigap provider before making any payments to your provider.
If you have a deductible or other co-pays or charges under your plan, you will then be billed by the provider for those amounts.
What is not covered by Medicare Supplement plans?
There are some things that Medicare does not cover and if Medicare doesn’t cover the cost, your Medicare Supplement won’t cover it either. You will have to purchase insurance to cover these items in addition to your Medicare Supplement premiums. These things include:
· Routine dental exams and services
· Routine vision exams, services and glasses/contact
· Routine hearing exams, services and hearing aids
· Long-term care
· Retail Prescription drugs (Note that you are required to have a Part D drug plan if you enroll in a Medicare Supplement plan or could face a penalty if you enroll later on, which will cover your prescription drugs)
If you have questions about how to find the best Medicare coverage for you, we are here to help. Contact us for no cost, no obligation personalized advice.