Looking at Your Medigap Options

A Medigap policy, also known as Medicare supplement, is designed to supplement the medical coverage provided through the Medicare program. Since Medigap policies vary significantly in cost and scope, finding a policy that meets your specific needs is essential.

Do I Need a Medigap Policy?

The first thing to ask yourself is if you need a Medigap policy. As mentioned above, these are policies designed to supplement Medicare Part A or B, and Medigap fills in the gaps left by medical expenses not covered by Medicare.

If you’ve used your standard Medicare, you’re already aware that you’re responsible for coinsurance, co-payments, and deductibles. You are also mindful that there are some services not covered under Medicare. A Medigap policy can benefit those wanting more health care services and benefits and lower their out-of-pocket medical expenses.

What Are the Medigap Options?

There are eleven standardized Medigap plan types available, each featuring different benefits. These are labeled A through N. So, when considering a Medigap plan, it’s essential to understand precisely how original Medicare isn’t meeting your current and future coverage needs to know what dream best suits you. There will be more extensive coverage and benefits with A through G plans than with Medigap K and L plans. However, they also cost more. Another consideration is that newly purchased Medigap policies can’t contain prescription drug coverage.

Plan A is the most basic Medigap policy, covering the core benefits such as Part A coinsurance, hospital costs, and hospice care coinsurance.

Plan F is the most comprehensive Medigap policy, covering all the benefits offered by the other Medigap plans and an additional benefit for excess charges, which are charges above the Medicare-approved amount for a service.

Plan G is similar to Plan F, but it does not cover the excess charges benefit. However, Plan G may have a lower premium than Plan F, making it a more affordable option for some individuals.

Plan N is another popular Medigap option that covers most of the benefits offered by the other plans. Still, it requires you to pay copays for certain services, such as office and emergency room visits.

Medigap Pricing

You can obtain a Medigap policy through a private insurance carrier. These plans are standardized nationwide, meaning you’ll receive the same plan-specific benefits no matter what page sells the procedure to you. What does differ from page to page is the price of the various Medigap plans. In other words, you’ll receive the same benefits and coverage regardless of the airline. But you might pay more for it on one page versus another. There are many reasons behind the cost variations, including the following:

* There might be discount eligibility from the carrier, such as for non-smokers or groups.

Medicare Select

* Medigap Select plans are a type of Medigap policy that insurance companies sell to individuals who live in specific service areas. These plans may have lower premiums but only allow you to see healthcare providers within the insurance company’s network.

High Deductible

* Standardized Medigap F plans have a high-deductible option, which reduces premiums in exchange for you paying upfront and a higher deductible.

Attained Age, Community Rated

* Medigap policies can be either community-rated or age rating. Community-rated policies have the same premium for all policyholders, regardless of age, and Age-rated policies have tips that increase as you age.

Age-rated policies have premiums that increase as you reach certain ages, such as 65, 70, or 75. This means your premium will increase as you get older, even if you have had the same policy for many years.

Pre-Existing Conditions

* Underwriting issues may also affect the price. If you apply during your Medigap open enrollment period. (That is the six-month window that starts the month that you enroll in Medicare Part B and are at least age 65) Then the carrier can’t apply individualized underwriting. This is also true during guaranteed-issue periods set aside by state or federal law.

The best way to find the right Medigap policy at the right price is through comparison shopping. Remember that there are standardized plans (A through N) to ensure you’re comparing the same method (s) from carrier to carrier. Pay close attention to how the premium is set and the specific factors influencing the price. Also, remember that not all insurance carriers will offer all eleven standardized Medigap policy types. Your insurance agent (Brian Gruss, 352-508-4221), Medicare office, or state insurance department can usually list different carriers in your area and their Medigap offerings.