Medicare is the American single-payer health insurance system for people ages 65 and older, as well as people with end-stage renal failure. Users can supplement their Medicare coverage is with one of several types of Medigap plans. These plans help to cover the costs of deductibles and copays you still have to pay under Medicare. Here is everything you need to know about Medigap Insurance.
Medigap Insurance Explained
Medicare insurance does a pretty good job of covering most things patients want, but there are some costs everyone must pay. These include monthly premiums, deductibles, and out of pocket payments for things not covered by Medicare. Unlike traditional Medicare itself, Medigap plans are from private insurance companies. They are only for people who already have Medicare Part A & Medicare Part B, which cover hospital and medical services respectively. If you have a Medicare Advantage plan, you are not eligible for Medigap Insurance.
Medigap gets its name because it covers the gaps left by regular Medicare, whether that means covering financial costs or covering things Medicare does not typically offer coverage for. If you get Medigap Insurance you still need to get Medicare Part D for prescription drug coverage because Medigap plans do not include this.
What Does Medigap Cover?
Each Medigap plan covers something different, but some examples of coverage you can get include coinsurance even after you have used all your Medicare benefits, coverage for a skilled nursing facility, or a cap for what you will pay out of pocket overall. Some plans even cover international travel, so you can enjoy your retirement and old age worry free.
Medigap Plan A
The first plan listed is a somewhat modest one. It offers coinsurance for Medicare Part A hospital insurance, even up to a year after you have used up your Medicare benefits. It has coinsurance for Part B medical insurance, coverage for your first three pints of blood used and coinsurance for hospice care.
Medigap Plan B
Medigap Plan B has all the same coverage as Plan A, but it also adds in coverage for your Medicare Part A deductible which is going up to $1,364 in 2019.
Medigap Plan C
Plan C is very similar to Plan B with a few additions to the gaps in Medicare it covers. It offers everything in Plan B, with the addition of hospice coinsurance. This is a wonderful end-of-life benefit that will remove the stress from your family members and allow you to transition with peace surrounded by those you love - not stressed about money. It also includes coverage for your Medicare Part B deductible, which is only $185. Another benefit of Plan C is coverage for 80% of your medical expenses when traveling internationally.
Medigap Plan D
When you get Plan D, you will get everything found in Plan C except for coverage for your Medicare Part B deductible, which, for many, is a nominal expense to begin with.
Medigap Plan F
Medigap Plan F has two different options. First, there is a high deductible version in which you will pay $2,320 out of pocket before the plan kicks in. The other version has no deductible. Both plans cover everything in Medigap Plan C, plus Medicare Part B excess charges that occur when a doctor is legally allowed to charge more than the amount Medicare will cover for an appointment or procedure.
Medigap Plan G
G is very similar to Plan F with a few minor differences. It has no option for a higher deductible. It covers everything in Medigap Plan F except for the Medicare Part B deductible of $185.
Medigap Plan K
Medigap Plan K is a great plan that differs from the other ones in many ways. You get 100% coverage for Medicare Part A hospital coinsurance, and 50% coverage for Part B medical coinsurance, your first three pints of blood, Medicare Part A hospice coinsurance, skilled nursing facility coinsurance and your Part A Deductible. It helps to defray the costs but doesn't get rid of them entirely. This plan has an out of pocket limit of $5,560 in 2019.
Medigap Plan L
This Medigap plan is exactly the same as Plan K, except you will get 75% coverage for everything with partial coverage, instead of 50%. Plan L has an out of pocket cap of $2,780 in 2019.
Medigap Plan M
Medigap Plan M has some features of a few of the aforementioned plans. It basically has everything in Plan C, including hospice insurance, part A & B coinsurance, skilled care facility coinsurance and coverage for your first three pints of blood. The main difference is it only offers 50% coverage for your Medicare Part A deductible.
Medigap Plan N
Medigap Plan N is identical to Plan C except you will typically pay a copay of $20 for doctor's visits and a copay of $50 for ER visits.Three states - Massachusetts, Minnesota and Wisconsin - have different Medigap plans available.
Is There a Difference Between Medigap and Medicare Supplemental Insurance?
People tend to use the terms Medigap and Medicare Supplemental Insurance interchangeably but they refer to the same thing. There is no difference between Medigap plans and Medicare Supplemental Insurance. Medigap is simply the name for Medicare Supplemental insurance and Medigap plans are the only supplemental insurance available for Medicare plans.
Who Needs Medigap?
Anyone eligible for Medicare can get a Medigap plan to help cover the expenses associated with Medicare and healthcare as you age. Whether or not you need it is totally up to you, as these plans are fully optional. You might consider it if you enjoy traveling because the 80% foreign travel benefit on many of the plans helps to cover costs if something happens while you're abroad.
You should also consider the cost and how much it will save you in the long run. The most robust Medigap plans have higher monthly premiums. The more modest plans have lower premiums. When you consider how much a plan could save you in the long run through coinsurance and deductible coverage, it may very well be worth it. Each company prices their plans differently, so be sure to compare at least a few different plans to get the best monthly premium.
How to Sign up for Medigap Health Insurance
Signing up for Medigap insurance is as easy as signing up for Medicare. You must either be age 65 or over, or have one of several health conditions that also qualify you for Medicare. When you're ready to choose a plan for supplemental Medicare insurance, make sure to visit Quick Medigap to see what plans are available in your area.
The Bottom Line
A Medigap plan can be a great addition to your Medicare health insurance plan. It helps to cover the gaps and costs associated with Medicare coverage. With so many different types of plans, it may seem a bit confusing, but thanks to our guide you now have a solid grasp on how Medigap plans can help you.