What is Medicare Supplement (Medigap) Insurance?
A Medicare Supplement (Medigap) insurance, sold by private companies, can help pay some of the health care costs that Original Medicare doesn’t cover, like co-payments, coinsurance, and deductibles.
If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Your Medigap policy pays its share.
A Medigap 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.
What you need to know about Medicare Supplement policies
- You must have Medicare Part A and Part B.
- If you have a Medicare Advantage Plan, you can switch to a Medicare Supplement insurance policy, but make sure you can leave the Medicare Advantage Plan before your Medicare Supplement insurance policy begins.
- You pay the private insurance company a monthly premium for your Medicare Supplement insurance policy in addition to the monthly Part B premium that you pay to Medicare.
- A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you'll each have to buy separate policies.
- You can buy a Medicare Supplement insurance policy from any insurance company that's licensed in your state to sell one.
- Any standardized Medicare Supplement insurance policy is guaranteed renewable even if you have health problems. This means the insurance company can't cancel your Medicare Supplement insurance policy as long as you pay the premium.
Features of ALL Medicare Supplement Plans
- 30-day free look - return any policy for any reason within 30 days after receipt for a full refund of all premiums paid.
- Renewal guaranteed - no worries of reduced benefits or canceled coverage for the life of the policy, as long as the premiums are paid on time.
- Freedom to choose your doctors - you control and choose the physicians who you trust for your care. Go direct to your doctors - you can go directly to the physicians and specialists you choose without pre-certifications and pre-approvals
- Benefits stay the same - you always know what your benefits are, no surprises or re-evaluations year-after-year.
- Portable coverage - you are not restricted to use a network of healthcare providers. If you move, your coverage goes with you.
- If you have any questions or concerns, please contact me at any time and I will be happy to go over with you in greater detail. I make myself available to my clients 24 hours a day, 7 days a week. I look forward to speaking with you again soon.
Do I need Medicare Supplement Insurance If I have Medicare already?
While Part A is free for most beneficiaries, it comes with a $1,556 deductible per benefit period. And although Part B comes with a low $233 per-year deductible, you typically pay 20% of the remainder for most doctor services — including while you’re a hospital inpatient — as well as outpatient therapy, Part B Medications,sych as Injections at doctors office, and durable medical equipment such as wheelchairs, cpap supplies, or oxygen.
That 20% is after your deductible, There’s no limit to how much you’d pay out of pocket
If you have a heart attack, need multiple surgeries and hospital visits, you could literally end up bankrupt.
Heart bypass surgery can cost more than $100,000, according to Statista. Heart-valve replacement can run upwards of $170,000. For illustration purposes only: If all those charges were delivered through Part B, your 20% share would be at least $20,000 for the bypass and $34,000 for the valve replacement.
When you first enroll in Medicare Part B, you get six months to purchase a Medigap policy without an insurance company nosing through your health history and deciding whether to insure you. After that, unless your state allows special exceptions, you have to go through medical underwriting.
While a number of companies offer Medigap insurance, they can only offer policies from a list of about 10 standardized plans. Each is simply assigned a letter: A, B, C, D, F, G, K, L, M and N. Some states also offer a high-deductible version of Plan F.
This standardization means that, say, Plan G at one insurance company is the same as Plan G at another