If you are reading this, it is probably because you or a loved one have questions about Medicare, its costs and benefits, and what you can do if traditional Medicare is not enough. Maybe you have heard about Medigap, or Medicare supplemental Insurance and wanted to find out more.
Medicare, in its broad terms, consists of Medicare A, hospital insurance, and Medicare B, medical insurance. Each part has its own cost sharing breakdown.
Sample Cost sharing under Medicare Part B- Medical Insurance
• Annual deductible – You pay $147 before Medicare Part B benefits begin.
• Physician coinsurance – Assuming your doctor accepts Medicare, Medicare pays 80% of your approved amount, your out of pocket costs are the remaining 20%.
• Medical equipment and supplies – Medicare pays up to 80% of the approved amount. You pay the rest. *
After reading the above you may be feeling discouraged, these costs can quickly add up. That is where Medigap insurance, also known as Medicare supplemental insurance, comes in to help cover many of the most common out of pocket expenses you may encounter. There are only a few basic things you need to know to get started on your journey to better coverage.
• You must have Medicare A and Medicare B to be qualified for supplemental insurance.**
• Medigap policies cover only one person. Your spouse will need to obtain their own plan.
• Medigap policies are guaranteed renewable as long as you pay your premium.
• Medigap policies will not cover everything. For example, current Medigap policies do not cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.
• Medigap policies are standardized and tightly regulated by Federal and state governments.
o “Each standardized Medigap policy must offer the same basic benefits, no matter which insurance company sells it. Cost is usually the only difference between Medigap policies with the same letter sold by different insurance companies.” (2012 Choosing a Medigap Policy, Center for Medicare & Medicaid Services).
o For example, every carrier in your area that offers Medigap F (they are lettered A-N) must include the same benefits, no matter the premium. This makes easy for you to choose a Medicare Supplement for the first time or to find a more affordable policy without worry.
If you would like to find out phow you can receive the best combination of benefits with Medicare and Medigap, please call 1-800-Medigap or visit and let them help you on your journey to better health care coverage today!
*Note that the Medicare approved amount can be less than the actual charge, so you could pay more than 20% of the total cost.
** If you have a Medicare Advantage Plan, you can apply for a Medigap policy, but make sure you can leave the Medicare Advantage Plan and transition to traditional Medicare before your Medigap policy begins.
If you have a Medicare Medical Savings Account (MSA) Plan you are not eligible for Medigap.
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