Medicare’s Supplement Insurance Program – Medigap

Medicare  Supplement  Insurance -Medigap- is a private health insurance policy that is designed to  supplement  Original Medicare (Part A and Part B). Medigap is provided by private health insurance companies but run by Medicare. Medigap helps pay some of the health care costs that Original Medicare does not cover (“gaps” such as copayments, coinsurance and deductibles) as well as certain services that Medicare doesn’t cover at all. If you have Original Medicare and a Medigap Policy, Medicare pays its share of the Medicare approved amounts for covered health care costs, followed by your Medigap policy’s payment.

Every Medigap policy must follow both federal and state laws. Medigap policies are standardized and identified by letters A-L. Each policy must offer the same basic benefits no matter which health insurance carrier sells it, the only difference will be the price each carrier offers.

Policy A offers the basic and core benefits while the other eleven policies contain the basic benefits as well as a few additional benefits. Plan A offers the following benefits:

  • Part A Hospital Coinsurance for Days 61-90
  • Part A Hospital Lifetime Reserve Coinsurance for Days 91-150
  • 365 Lifetime Hospital days beyond Medicare coverage
  • Part B 20% Coinsurance
  • Part A and Part B 3 pint blood deducible

The remaining policies (B through L) offer a different combination of the following benefits:

  • Part A Skilled Nursing Facility Coinsurance for days 21-100
  • Part A hospital deductible
  • Part B deductible
  • Foreign Travel Emergency coverage
  • At Home Recovery
  • Preventive medical care

When you buy a Medigap policy, you must have Medicare Part A and Medicare Part B. You will have to pay a premium for both Medicare Part B and your Medigap policy.

However, be advised that many benefits are not covered under any Medigap, including:

  • Dental Care
  • Hearing Aids
  • Prescription drug costs that exceed $3,000 per year
  • Private duty nursing
  • Skilled Nursing care after 100 days
  • Vision Care

Please note that Plans E, H, I and J are no longer sold (as of 2012). But if you already have one, you are allowed to continue receiving benefits.

Lastly, the Medicare insurance experts at MedicareSolutions are available to help you find a Medigap Plan that meets your needs. Please visit http://www.medicaresolutions.com/medigap.asp for a user-friendly resource that highlights each Medigap Plan available to you. Click on a specific plan and you will be able to read more on what benefits that plan offers.