Basics of Medigap

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12 Basics of Medigap

Many people feel the need to buy supplemental insurance with Original Medicare. Part A and Part B, which make up Original Medicare come with many additional costs which must be paid when services are taken through the plans. There are deductibles, copayments and coinsurance amounts which the member must pay out of his pocket. These out-of-pocket payments are covered by the secondary insurance or supplemental insurance called Medigap.

Medigap plans have to be bought from private insurance companies and must be used with Original Medicare plans. When a medical service is taken by a member which is covered under Part A or Part B, Medicare first pays its share and the remaining is paid by Medigap as per the plan terms.

Some Important Points to Remember Regarding Medigap

  • Medigap and Medicare Advantage are not the same thing –they are used for different purposes.
  • Enrollment into Medicare Part A and Part B is a must for you to buy Medigap plans
  • Medigap and Medicare Advantage plans cannot be kept by anyone at the same time If you have a Medigap plan and want to keep it, you cannot buy Medicare Advantage
  • Medigap plans do not cover couples in the same plan – each spouse has to buy his or her own Medigap plan
  • Medigap plans do not cover prescription drugs anymore. You have to buy a separate prescription drug plan, Part D, with Original Medicare to get prescription drug coverage
  • Medigap plans require the payment of a monthly premium to the insurance company from which they has been bought. You have to keep paying the premiums for Part B along with Medigap premiums
  • Insurance companies selling Medigap plans are bound to renew your plan even if you have health conditions. They can discontinue your coverage only if you stop paying the monthly premiums
  • You have to choose a Medigap plan from among the ones available in your area
  • You cannot buy a Medigap plan if you have a Medicare Medical Savings Account
  • Medigap plans do not provide coverage for vision, dental or hearing and long-term care services
  • Medigap plans cannot be used with any other government funded health insurance plan
  • You can drop or switch your Medigap plans provided you do it during the stipulated period

Medigap plans can help to save the out -of- pocket expenses associated with Original Medicare and give additional benefits.