Medicare Supplemental Insurance, also known as Medigap, covers voids left behind by Medicare coverage. Supplemental insurance is designed to assist with copays, coinsurance, and deductibles. Medigap is provided by private insurance plans approved by Medicare, but the cost of Medigap coverage is paid by the insured party only. Parties who are participants in Part C Medicare coverage (aka Medicare Advantage Plans) are not eligible for Medigap coverage. In fact, it is illegal for insurance representatives to sell Medigap coverage to any individual enrolled in a Medicare Advantage Plan.
Medigap can be of great assistance to parties with healthcare costs. The supplemental coverage can help with preventative care costs, blood administration costs, Medicare Plan A and B deductibles and extra costs not covered by Medicare. There are 12 different Medigap plans approved by Medicare (labeled A-L), and each have their own level of comprehensiveness. There are numerous options that are designed to meet the needs of each individual Medicare recipients. For example, Medigap Plan E assists Medicare A recipients with deductibles, but Medigap Plan F assists with Medicare B deductibles.
Medigap plans F and J are "high deductible" plans that carry a $2000.00 deductible. The cost advantage to these plans is lower premium rates when compared to other plans, but the ailing party must pay a higher deductible once Medigap coverage kicks in.
Private insurance companies cannot, by law, refuse to sell Medigap to eligible parties if: the plan is offered in the purchasing party's state; the plan is offered in a state where the purchasing party is moving to; have dropped Medigap for a Medicare Advantage Plan, and want to switch back within one year; the eligible party moves out of an area where Medicare Advantage is offered, or if Medigap A, B, C, D, F, K or I is sold by any Medigap provider in the eligible party's state. These rules protect potential Medigap purchasers from discrimination by Medigap providers, regardless of preexisting conditions or medical history.
The cost of these plans vary by the breadth of coverage. The only difference between the plans is the premium as offered by the private insurance companies. The amount of coverage amongst like plans does not change. Since the cost can vary greatly among insurance providers for the same coverage, it is important to comparison shop for the best rate.
Medigap plans K and L are the only plans that cover partial hospice costs, as well as skilled nursing costs. Plans K and L are best for those with terminal illness or those eligible for hospice care. Medigap plans A-J are best suited for members of either Medicare A or B plans.
Medigap plans do not cover prescription drug costs. The only exceptions are for parties who purchased a Medigap prescription drug plan prior to January 1, 2006. Otherwise, Medicare D offers prescription drug coverage to parties receiving Medicare, and therefore there is no need for Medigap to cover prescription drug costs.
Medicare urges all eligible participants to purchase Medigap during his or her open enrollment period. Medigap's greatest asset is in its ability to assist with high copayments and with acute care procedures not covered by Medicare A and B. The US federal government urges all Medicare recipients to enroll in Supplemental Medicare Insurance as a vanguard for the unexpected.
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