Your loved one is turning 65 and looking into Medicare. You've probably heard whispers of Medigap, but what exactly is it? Think of it as a safety net for Medicare. Medigap picks up the tab for medical costs Original Medicare doesn't cover. But is Medigap the right fit for your caregiving journey?
Medigap is supplemental insurance provided by private companies to pay some of the out-of-pocket costs of Original Medicare.
A Medicare supplement might include Medicare Part A (hospital insurance) and Part B (medical insurance). Medigap fills in some of the medical services left out by Medicare coverage.
Medigap policies, offered by private insurance companies, are a lifesaver when rounding out Original Medicare. The additional coverage aids with those costly deductibles, copays, and coinsurance.
Medigap policies, offered by private insurance companies, are a lifesaver when rounding out Original Medicare. The additional coverage aids with those costly deductibles, copays, and coinsurance.
Medigap policies differ from Medicare Advantage Plans (Part C) as they only supplement Original Medicare's coverage gaps. Supplement plans are available to anyone signed up for Original Medicare.
Ten types of Medigap plans are offered in most states, named by letters: A–D, F, G, and K–N.
If you have a Medigap policy and get care, Medicare will pay its share of the Medicare‑approved amount for covered healthcare costs. Then, your Medigap policy will pay its share. Medicare doesn't pay any of the costs of buying a Medigap policy.
Remember, Medigap plans protect you nationwide, so you can see any provider who accepts Medicare without worrying about out-of-pocket costs. It's an excellent backup plan wherever you go.
And here's a bonus: When your loved one first enrolls in Medicare at age 65, there is a six-month open enrollment period. Take your time and find the coverage that fits their needs.
While private insurers offer Medigap and Medicare Advantage plans, they work differently.
Medicare Advantage policies bundle together Original Medicare, prescription drug coverage, and sometimes additional benefits like dental care, vision coverage, and hearing aids. Instead of using Original Medicare directly, your loved one would enroll in a Medicare Advantage policy.
Medigap is the fallback option for Original Medicare. This supplemental policy covers the missing plan options that Original Medicare leaves behind.
Medigap plans pay for services like emergency room visits, hospice care, and preventative screenings. They also help with out-of-pocket costs like deductibles, copays, or coinsurance.
With Medigap, your loved one maintains their Original Medicare insurance plan benefits and adds this additional coverage.
The answer depends on your loved one's specific needs and preferences.
Medigap might be the best health insurance coverage if they like their current network providers.
However, a Medicare Advantage benefits package might be better if they need additional medical services or more comprehensive coverage.
Chat with your loved one's health care providers, pharmacists, and licensed insurance agents. Review all options available:
Remember, the best plan for your loved one entirely depends on their medical priorities. Take the time to research and compare alternatives to find the right one.
Medigap aids with deductibles, copays, and coinsurance for hospital stays, medical visits, and other expenses.
Some policies even offer extra perks like emergency travel coverage, durable medical equipment coverage, and at-home recovery care.
While Medigap plans may cost more upfront, they save a lot of cash in the long run. Medigap policies reduce hospital costs so your loved one gets vital medical care without breaking the bank.
While Medigap fills many gaps in Medicare coverage, there are certain things these policies don't manage. For instance, Medigap doesn't include:
Want to cover all your bases when it comes to healthcare costs?
Select the choice that best serves your family's needs and budget, and you'll be well on your way to enjoying peace of mind when it comes to medical costs.
Medigap plan premiums vary widely based on location, age, plan type, and insurance company.
How can a family caregiver decide on the right plan?
The more generous the plan benefits, the higher the premium costs. Premiums increase annually as your care recipient ages.
Family caregivers should compare policies with identical letters across different insurance companies when comparing plans. For example, Plan F from one insurer will have the same benefits as Plan F from another.
Focus on pricing differences between the same policies.
Note this is a fictional example. Policies will differ based on medical conditions, insurance company, health conditions, and other factors.
There is a 6-month Medigap open enrollment period when your loved one first enrolls in Medicare Part B at age 65.
Under this window, insurance companies must sell a policy regardless of pre-existing health conditions. After this enrollment period, your loved one may be denied benefits or pay more based on medical history.
Yes, your loved one can still apply for Medigap after open enrollment. Still, the insurer can refuse the application or increase premiums if they have pre-existing conditions.
So, it pays to carefully consider Medigap during the initial enrollment period. Some states also offer other open enrollment situations.
Choose the policy that fits your household's unique healthcare needs. Evaluate your loved one's health, finances, and coverage requirements. For example, Medigap could make all the difference if they have frequent doctor visits or need broader coverage than Original Medicare offers. Higher premiums might be a concern for fixed-income policyholders.
Talk to family and financial advisors to make an informed decision. With a bit of research, you can make the best decision for your loved one's future. It's time to take control of healthcare.
