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Pros and Cons of the Medigap Policy
Author David Schneider | Nov 15,2007
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You qualify for Medicare benefits once reaching 65. Medicare removes much of burden from health care costs. However, the original Medicare plan is not meant to provide full coverage.
You have many options from which to choose for fixing the fissures from original Medicare. One option is Medigap supplemental insurance. Read on for the pros and cons of the Medigap policy.
What is Medigap?
Medigap is Medicare supplemental insurance that works specifically with Medicare. It covers gaps in health care from the original Medicare plan. Basically, where Medicare leaves off, the Medigap policy takes over, assisting with coinsurance, co-payments and deductibles.
What is Covered Under a Medigap Policy?
There are 12 different plans under the Medigap policy, named A through L. Plan A provides basic coverage, called a “core policy.” The remaining plans incorporate basic coverage and different groupings of additional coverage, such as nursing care, insurance deductibles, preventative care, coverage while traveling and home recovery care. Going down the line, Medigap plan L provides the most coverage, but is also the most expensive.
All Medigap policies are available through private insurance in every state, save for Wisconsin, Minnesota and Michigan. State and federal laws regulate plans. While you won’t find any difference in coverage levels, monthly premiums vary depending on the insurance policy.
Medigap Lets You Choose Your Doctor
One of the greatest benefits to a Medigap policy is the freedom to choose your doctor. There’s no network of medical professionals to contend with on this plan. The only provision being that your doctor has to accept Medicare.
Gaps in Medigap Policies
Medigap covers a lot of ground as a supplemental insurance policy. However, you should be aware of a number of important gabs. Medigap policies do not provide dental or vision coverage, hearing aids, long-term care or assisted living. Prescription drug coverage is also not included with any Medigap policy and must be purchased separately.
Medigap Policies and Pre-existing Health Conditions
If you have a pre-existing condition, there is a chance that you may not receive health care coverage right away. In some cases, the private insurance company can order a six-month waiting period before you receive care for a pre-existing health issue. A waiting period usually applies if treatment for the condition occurs within six months prior to purchasing a Medigap policy.
Medigap Policies Guarantee Enrollment and Renewal
You have six months from the sign-up date for Medicare Parts A and B to purchase guaranteed coverage under a Medigap policy. Medigap policies purchased after 1990 are also guaranteed renewal. In most cases, as long as you pay the premiums and avoid committing fraud, you will never be denied coverage.
When choosing a Medigap policy, consider your health care needs and the payments you can afford. Since Medigap plans vary, take time to evaluate each one carefully. As you budget for a Medigap policy, remember to leave room for additional health care expenses, such as prescription drug coverage. You can also choose a Medicare advantage plan, which already includes prescription drug coverage.
Once you’ve located a plan that works, the next step is to shop around. A Web site designed for comparison shopping allows you to evaluate multiple quotes at the same time. Before purchasing a Medigap policy, verify the financial health of the private insurance company and double check that Medicare has approved them.
You qualify for Medicare benefits once reaching 65. Medicare removes much of burden from health care costs. However, the original Medicare plan is not meant to provide full coverage.
You have many options from which to choose for fixing the fissures from original Medicare. One option is Medigap supplemental insurance. Read on for the pros and cons of the Medigap policy.
What is Medigap?
Medigap is Medicare supplemental insurance that works specifically with Medicare. It covers gaps in health care from the original Medicare plan. Basically, where Medicare leaves off, the Medigap policy takes over, assisting with coinsurance, co-payments and deductibles.
What is Covered Under a Medigap Policy?
There are 12 different plans under the Medigap policy, named A through L. Plan A provides basic coverage, called a “core policy.” The remaining plans incorporate basic coverage and different groupings of additional coverage, such as nursing care, insurance deductibles, preventative care, coverage while traveling and home recovery care. Going down the line, Medigap plan L provides the most coverage, but is also the most expensive.
All Medigap policies are available through private insurance in every state, save for Wisconsin, Minnesota and Michigan. State and federal laws regulate plans. While you won’t find any difference in coverage levels, monthly premiums vary depending on the insurance policy.
Medigap Lets You Choose Your Doctor
One of the greatest benefits to a Medigap policy is the freedom to choose your doctor. There’s no network of medical professionals to contend with on this plan. The only provision being that your doctor has to accept Medicare.
Gaps in Medigap Policies
Medigap covers a lot of ground as a supplemental insurance policy. However, you should be aware of a number of important gabs. Medigap policies do not provide dental or vision coverage, hearing aids, long-term care or assisted living. Prescription drug coverage is also not included with any Medigap policy and must be purchased separately.
Medigap Policies and Pre-existing Health Conditions
If you have a pre-existing condition, there is a chance that you may not receive health care coverage right away. In some cases, the private insurance company can order a six-month waiting period before you receive care for a pre-existing health issue. A waiting period usually applies if treatment for the condition occurs within six months prior to purchasing a Medigap policy.
Medigap Policies Guarantee Enrollment and Renewal
You have six months from the sign-up date for Medicare Parts A and B to purchase guaranteed coverage under a Medigap policy. Medigap policies purchased after 1990 are also guaranteed renewal. In most cases, as long as you pay the premiums and avoid committing fraud, you will never be denied coverage.
When choosing a Medigap policy, consider your health care needs and the payments you can afford. Since Medigap plans vary, take time to evaluate each one carefully. As you budget for a Medigap policy, remember to leave room for additional health care expenses, such as prescription drug coverage. You can also choose a Medicare advantage plan, which already includes prescription drug coverage.
Once you’ve located a plan that works, the next step is to shop around. A Web site designed for comparison shopping allows you to evaluate multiple quotes at the same time. Before purchasing a Medigap policy, verify the financial health of the private insurance company and double check that Medicare has approved them. |
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