Medigap: What It Is, What It Covers, and How to Get It
One common concern that plagues many current and potential Medicare beneficiaries is the need for supplementary health insurance—plans that bridge financial gaps left by Original Medicare (Parts A and B). The search for such a policy need not be complicated. The Medicare program itself offers access to supplemental, or “Medigap” plans. Here’s what you need to know about Medigap insurance.
What is Medigap?
Medigap is a type of supplemental health insurance specifically designed to help offset the costs that Original Medicare does not cover. These costs—known as gaps (hence the term “Medigap”)—run the gamut from copayments to coinsurance to deductibles, and can add up quicker than many Medicare beneficiaries anticipate.
The term “Medigap” is also often used interchangeably with “Medicare Supplement Plans.” You may still see these plans advertised as “Medigap insurance,” or in some cases (returning to the previous terminology), “Supplemental Medicare plans.”
What Does a Medigap Plan Cover?
The answer to this question can vary somewhat depending on the plan chosen. While plan options do vary from state to state, in general they cover one or more of the following:
• Copayments
• Coinsurance
• Excess charges
• Foreign travel emergency coverage
• Deductibles
• Temporary skilled nursing facility stays
• Hospice care
• Preventive services
• First three pints of blood for a transfusion
• Out-of-pocket maximum
Keep in mind that some of these services may not be covered under certain plans, and the coverage limits can vary from provider to provider. That’s why it’s always important to read the fine print and know exactly what’s covered before signing on the dotted line.
How to Get a Medigap Plan
Obtaining a Medigap plan is relatively straightforward. Although Medicare Supplement Plans don’t require approval from Medicare, you do need to be enrolled in both parts of Original Medicare (Part A and Part B).
After that, simply shop around for the plan that best fits your needs and budget. Because the plans are standardized, you’ll know the coverage you’re getting no matter which insurance company you choose. You’re also free to switch plans or cancel your plan any time without penalty or worry.
Do bear in mind, though, that Medigap plans do not cover long-term care expenses, vision or hearing aids, dental care, eyeglasses, or private-duty nursing. These items may need to be covered by other forms of insurance or out-of-pocket expenses.
Medigap plans can be helpful for bridge financial gaps left by Original Medicare. Whether you’re already on Medicare and looking for more coverage, or you’re approaching 65 and weighing your insurance options, you may want to consider MedicareSupplement plans. With the right plan, you can get the peace of mind you need knowing that you’re fully covered no matter what health situations you face.