What is Medigap ?

Jolie

Member
Sold by private insurance companies to pay some or all of the costs that Parts A and B don't cover.

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There are 10 standard plans, labeled “A” through “N.”

Coverage limits.

Medigap policies provide an added 365 days of hospital care during your lifetime. They don’t offer more days in a skilled nursing facility.

What is covered.

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Examples of items Medigap policies will help you with. For a complete list, see the specific policy's details.

What isn’t covered.

These policies help cover the costs not covered by Parts A and B; for instance, deductibles, copays, or coinsurance. They don’t cover long-term care; routine vision, dental, or hearing care; hearing aids or eyeglasses; or private-duty nursing.

Costs.

As a general rule, the more generous the coverage, the higher the premium. Premiums vary widely. And they may rise over time.

Your share of the costs.

Deductible. Some plans pay your Medicare Part B deductible and some companies offer high-deductible versions.

Copay. Some plans require Part B copays for doctor visits and emergency room trips.

Coinsurance. Some plans use coinsurance to split costs between you and the insurance company until you reach your out-of-pocket limit.

Enrolling

When can I join? You can buy a Medigap policy any time after you reach 65 and join Medicare Part B. They can’t consider your medical health history in setting your premium if you sign up during the 6 months after you turn 65. Depending on where you live, plans may be available to persons on Medicare due to a disability.

How do I sign up? Each private company that offers Medigap policies handles its own enrollment. To join, you’ll need to contact the company and ask how to join.

Can they refuse to cover me or delay coverage? Once your open enrollment period ends (up to six months after turning 65), insurers can refuse coverage or charge you a higher premium based on your health, or make you wait to get coverage for an illness you currently have. There are certain limited situations where you have the right to buy a plan, regardless of your health, after your open enrollment period ends.

Can I change my coverage later? You can drop a Medigap policy and apply for another one whenever you want.

How does renewal work? Medigap policies must be “guaranteed renewable.” That means the policy must be renewed automatically from year

 
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