If you or your loved one has Medicare insurance, it will only pay for a portion of his or her medical costs. The out-of-pocket medical costs can be substantial. One type of policy that you can purchase to supplement Medicare is called a Medigap policy. At Elder Care Direction, we can provide some advice about Medigap insurance and other ways that you might pay for your medical needs.
What is Medigap insurance?
Medigap insurance is a form of supplemental insurance that you can purchase from private companies. The purpose of Medigap insurance is to pay for the medical expenses that Medicare will not cover.
Medigap does not require that you see specific doctors or provide a list of procedures that it does not cover. This makes these policies invaluable for people who have trouble making the payments for the medical expenses that they have that are not covered by Medicare.
The difference between Medigap and Medicare Advantage Plans
Medigap coverage is supplemental insurance that is standardized. This means that all Medigap plans that are the same type are the same regardless of the insurance company that offers them.
Medicare Advantage plans are made up of multiple private medical insurance plans. Senior citizens have the choice to pick Medicare Advantage instead of Medicare. Some Medicare Advantage plans offer similar services to the services provided by Medicare, but some also offer additional services that Medicare does not cover.
How does Medigap work?
Medigap policies pay for medical costs that Medicare doesn’t cover when someone has sought medical treatment. Medigap policies are private plans, and there are different types that might be available in different states. Medigap may pay for some services that the person’s original Medicare will not cover.
If you decide to get Medigap coverage, you will want to review the benefits that are offered by different plans. Similar to other types of private insurance plans, Medigap insurance comes with copayments and deductibles. There are also some high-deductible Medigap plans that are available for lower premiums. You will want to make certain to check the deductible of any plan that you consider to make certain that the plan will help you when you need it. You can find out more about Medigap insurance and what it might cover on the Medicare.gov website.
Eligibility
People are eligible for Medicare and Medigap when they turn 65. They will enter into a period of eligibility for six months. To get a Medigap policy, you must first enroll in Medicare parts A and B. During the six-month eligibility period, you can enroll in Medicare and Medigap regardless of your health history, and you cannot be forced to pay higher rates if you enroll during this eligibility period.
People who are older and who are new to Medicare part B start an enrollment period. They are given rights to sign up for Medigap without being denied coverage during this enrollment period. If you have Medicare Advantage part C, you will not be able to get Medigap insurance.
If you do not get a Medigap policy during the open enrollment period, you may be turned down for coverage based on your pre-existing conditions. This makes it important for you to sign up for Medigap as soon as you become eligible so that you can prevent problems.
If you are younger than 65 but have a disability that makes you eligible for Medicare, you may not be able to get Medigap coverage. If you are eligible, you may have to pay a higher premium based on your pre-existing condition.
Learn more about Medigap coverage with Elder Care Direction
At Elder Care Direction, we understand how costly your medical expenses can be when you are older. We can help you to figure out the options that you have and to find policies that are affordable. Call us today to schedule a consultation.
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