What's Medicare Supplement Insurance (Medigap)?
A Medicare Supplement Insurance (Medigap) policy helps pay some of the health care costs that Original Medicare doesn't cover, like:
Medigap policies are sold by private companies.
Some Medicare Supplement policies also cover services that Original Medicare doesn't cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medicare Supplement policy, here's what happens:
Medicare will pay its share of the Medicare-approved amount for covered health care costs.
Then, your Medicare Supplement policy pays its share.
8 things to know about Medicare Supplements
You must have Medicare Part A and Part B.
A Medicare Supplement policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.
You pay the private insurance company a monthly premium for your Medicare Supplement. You pay this monthly premium in addition to the monthly Part B premium that you pay to Medicare.
A Medicare Supplement policy only covers one person. If you and your spouse both want Medicare Supplement coverage, you'll each have to buy separate policies.
You can buy a Medicare Supplement from any insurance company that's licensed in your state to sell one.
Any standardized Medicare Supplement policy is guaranteed renewable even if you have health problems. This means the insurance company can't cancel your Medicare Supplement policy as long as you pay the premium.
Some Medicare Supplements sold in the past cover prescription drugs. But, Medicare Supplement policies sold after January 1, 2006 aren't allowed to include prescription drug coverage. If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D)
It's illegal for anyone to sell you a Medicare Supplement policy if you have a Medicare Advantage Plan, unless you're switching back to Original Medicare.
Medicare Supplements don't cover everything
Medicare Supplements generally don't cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.
Medicare Supplement plans
The Medigap policy you purchase must be clearly identified as “Medicare Supplement Insurance.” In most states, there are up to 10 different Medigap basic benefits options to choose from. Plans are labeled A, B, C, D, F, G, K, L, M, and N. Plans with innovative benefits may be available and offered by a company. In Massachusetts, Minnesota and Wisconsin, Medigap policies are standardized in a different way.
All insurance companies selling a particular Medigap plan type in your area must offer the same basic benefits in that plan type, but may offer it at different prices. So, you may want to shop for the best price but it's important to know the history of the rate increases as well as the financial strength of a particular company. An insurance agent can give you this information.
The best time to buy Medicare Supplements is when you enroll in Medicare Part B. You will be in your Open Enrollment Period (6 months from your Part B effective date) which means that you can enroll in any Supplement plan without being asked about your medical history.
After the 6 month Open Enrollment most insurance companies can decline an applicant if they have certain medical conditions. An exception is Blue Cross Blue Shield of Illinois- they will always accept new applicants -which is really great!
If you already have a Supplement and your premiums are increasing, you can shop for a less expensive plan at any time. You can enroll in the same plan from a different company or switch to a different plan (for example from Plan F to Plan N).
For instance, a 76- year old man from Long Grove, IL may get Plan F from Blue Cross Blue Shield for $276 per month or he can get exactly the same plan from a different carrier (Prosperity Life) for only $201 per month. There is absolutely no difference in benefits.
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