Looking for a Medigap for Beginners overview that isn’t full of jargon or insurance buzzwords? We will give you an overview that will explain what Medigap is, demystify key terms, and help you decide if Medigap is right for you.
If you are in the group of people that call themselves “dummies” because they cannot understand these plans, you are not alone! You are not a dummy! Even the founders here at Senior65.com were overwhelmed by Medigap at first. This guide will explain Medigap in simple terms.
Medigap for Beginners Overview
Medigap, also known as Medicare Supplement Insurance, is a type of additional insurance plan for those already on Medicare. Not sure what Medicare is? That is ok. Just click on our Medicare Overview page.
Medigap is designed to cover costs not covered by Medicare that patients typically have to pay for. This is known as “out-of-pocket costs” and you can think of it as money that is coming out of your own pocket. And you want to hold on to your own money…right? Medigap pays some or all of those out-of-pocket fees for you.
Beginners Guide to who sells Medigap
Medigap policies are sold by private insurance companies. Many you may have already heard of like Blue Cross or Humana and some that you have never heard of like Globe Life. Here is the key thing you should know about companies that sell Medigap… plans with the same name (like Medigap plan F) have the exact same benefits, network of doctors, and facilities regardless of who sells them.
Medigap plans are regulated by the government so they are standardized. This means that they offer the same basic benefits regardless of the insurance company offering the policy. So a Medigap Plan G from Cigna will be identical in benefits and doctor access to Medigap Plan G with Aetna. We will get into the Medigap letters later.
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Beginners Guide to what Medigap covers
Generally, Medigap policies CAN cover the following:
- Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
- Part B coinsurance or copayment
- Blood (first 3 pints)
- Part A hospice care coinsurance or copayment
- Skilled nursing facility care coinsurance
- Part A deductible
- Part B deductible
- Part B excess charges
- Foreign travel emergency (up to plan limits)
Note: Not all Medigap policies cover everything on the list above and most do not have coverage for vision or dental care, hearing aids, eyeglasses, or long-term care.
Beginners Guide to Who can Enroll in Medigap
It is available to individuals who meet the following criteria:
- They are enrolled in Medicare Part A and Part B.
- They must be a resident of the United States.
- They are age 65 or older.
Those who are under 65 can enroll in Medigap if they have a qualifying disability. (Source)
Beginners Guide to when should people enroll in Medigap?
The key thing to know is that there is a limited enrollment period when you first become eligible for Medicare during which you can enroll in a Medigap plan with no questions asked.
If you miss this initial enrollment period, insurance companies may charge higher monthly bill (somehow called premiums) or decline coverage based on your health status. If you miss this important initial deadline, you may really be calling yourself a dummy!
Most should enroll in Medigap during their initial enrollment period, which is a six-month window that begins when they are 65 years old and enrolled in Medicare Part B. During this time, insurance companies cannot deny coverage or charge higher premiums based on pre-existing health conditions.
If you miss your initial enrollment period, you may still be able to enroll in a Medigap policy, but insurance companies may charge higher premiums or decline coverage based on your health status. It’s recommended that you compare your options and shop around for the best policy that fits your needs and budget.
Enrolling in a Medigap policy during your initial enrollment period provides the best opportunity to secure comprehensive coverage at the lowest possible cost.
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Beginners Guide to Why should people enroll in Medigap?
People should consider enrolling in Medigap for the following reasons:
- To cover costs not covered by Original Medicare: Medigap is designed to cover out-of-pocket costs. This can help reduce huge medical bills.
- To provide peace of mind in the case of unexpected health events.
- To have more predictable healthcare costs: With a Medigap policy, individuals have more certainty about their healthcare expenses, as they know what costs are covered and what their responsibilities are.
- To have access to a wider network of doctors and hospitals: Medigap policies usually provide access to every doctor, facility, and specialist that Medicare does. Medicare currently offers the largest network of healthcare providers, including specialists, in the united states.
Beginners Guide to How much will Medigap cost?
The cost of a Medigap policy varies based on several factors, including:
- Your age: Younger individuals typically pay lower premiums, while older individuals tend to pay higher premiums.
- Your location: Premiums can vary by state and region, with some states having higher costs than others.
- The type of policy you choose: Different Medigap policies cover different benefits and the cost of a policy can depend on the level of coverage it provides.
- The insurance company you choose: Premiums can vary based on which insurance company is offering the policy.
To see prices get an instant Medigap quote here.
To receive help in selecting a plan visit our Medicare Insurance Recommendation Wizard or give Senior65.com at 800-930-7956. There is never a hidden fee or charge to work with us.