What is Medigap?

What is Medigap? What You Need To Know


Medigap Facts
Medigap, commonly known as Medicare supplemental insurance, is an insurance plan sold to fill-in Medicare insurance coverage.  Medigap, therefore, covers costs that you would otherwise have to pay from your account/pocket, such as copayments, coinsurance, overseas health cover, and deductibles.  Although Medigap may cover areas not covered by a Medicare insurance policy, the policy doesn’t cover some sectors such as eye care, private duty nursing, dental care, and long-term care.

Who is eligible for Medigap Policies?

Medigap goes hand in hand with Medicare insurance – meaning one has to be 65 years or older.  Seniors are automatically enrolled in a Medicare insurance plan, which covers at least 80% of their medical and hospitalization bills. Since the remaining 20% could be too much for an unemployed senior to off-set, most people are advised to buy Medigap to fill in the gap.  You therefore need to have Medicare Part A or Medicare Part B insurance to qualify for Medigap insurance policies. This means persons under the age of 65 do not qualify.

The best thing about applying for Medigap insurance cover is that your health and age do not play a role in the premium rates, for as long as you apply within the first six months of attaining 65 years.  As long as you have Medicare part B insurance, you can then apply for Medigap with an insurance company of your choice, and never have to worry about your health status.  Applying for coverage after the open enrollment period (6 months) can however be tricky, as insurance companies will consider all the risk factors when calculating your premium rates. There is a higher likelihood that the premium rates will be through the roof as soon the enrollment period is over.

One thing you need to know about Medigap is that you are required to pay monthly premiums the same way as it is for Medicare Part B.  Medigap premium rates may however vary from the type of plan you go for, your age, and the insurance company.  It would therefore be wise to window-shop for various Medigap insurance providers, cross-reference, and compare quotes before determining the right company to buy cover from. Aside from this, you need to ensure the plan is adequate to meet the 20% it’s supposed to cover.

Choosing a Medigap Plan

Just like any other insurance policy, it’s important that you shop around for the best and affordable provider within the state. Medigap plans vary depending on how much you are willing to spend on the same. For instance, cheaper Medigap plans offer fewer benefits and higher deductibles, while more expensive plans may offer additional benefits such as at-home recovery, Medicare deductibles, therapy, prescription drugs, and routine health checkups.

Although Medigap may provide additional cover that Medicare part A and B may not cover, it’s important that you pay monthly premiums on time.  Dropping the policy means no supplemental insurance, hence will have to pay the deductibles every time you are admitted to hospital.  It would therefore be much better if you shop around and buy an affordable policy from a trusted supplier. Talking to a licensed insurance broker/agent can also help you make a more informed decision on the same.

Latest Medigap News