Medicare Supplemental Insurance plans, also known as Medigap, are types of health insurance plans meant to help individuals pay for out-of-pocket expenses. Primarily, it provides coverage for monthly premiums, copayments, and coinsurance. With several different plan types, you may be able to find a supplement plan that works best for you. You can also speak with a licensed and experienced health insurance agent to answer any questions or concerns you may have.
To begin, Medigap does not replace your primary health insurance plan. Instead, it provides benefits for expenses your health insurance plan does not cover. It is important to note that, unlike Medicare, Medigap is not administered by the federal government. Alternatively, it is sold by private insurance companies. For consumer protection, there are regulations put in place that guarantees that enrolling members receive proper coverage. In addition to federal regulations, there are also state policies that can benefit potential enrollees.
To be eligible for Medigap, you must be enrolled in Original Medicare (Parts A and B). So, once you receive a covered health care service, Medicare will pay first. Afterward, Medigap will provide coverage for out-of-pocket expenses.
There are ten different available standardized Medigap plans. They are Plans: A, B, C, D, F, G, K, L, M, and N. Depending on your state of residence and insurance company, some of these plans may not be available. In fact, three states have different standardized plans.
Minnesota has a Basic Plan (similar to Plan A) and an Extended Basic Plan (similar to Plan N.
Meanwhile, Wisconsin only offers a Basic Plan (similar to Plan A.) Also, insurance companies can offer optional riders such as additional home health and foreign travel emergencies.
Massachusetts has a Core Plan (similar to Plan A), a Supplement 1 Plan (similar to Plan F), and a Supplement 1A Plan (similar to Plan G). In general, Supplement 1A provides the most value as it provides comprehensive coverage while being less expensive than Supplement 1.
It’s important to note that individuals who became Medicare-eligible after January 1st, 2020 are no longer allowed to purchase Medigap Plans C and F. Instead, they can purchase Plans D and G.
There are several different benefits you receive when enrolling in a Medigap plan. To start, you have a larger network of healthcare providers. As long as they accept Medicare, you should be able to visit any doctor and medical facility. Furthermore, your plan will automatically renew each year as long as you pay your monthly premiums on time. As a bonus, you will not need a referral to visit a specialist. Medigap allows you to have greater control of your health insurance and coverage.
While Medigap offers a variety of benefits, it does not cover everything. For instance, Medigap does not provide prescription drug coverage. For that, you must enroll in a Medicare Part D Plan. Also, Medigap will not cover dental, hearing, or vision services. Finally, it does not cover long-term care services.
Understandably, when trying to find the right Medigap plan, you must consider your financial circumstances. You should look for a plan that has an affordable monthly premium. In the worst instances, missing payments can result in a lapse of coverage or plan cancellation. In addition, it is important to ask your insurance company for annual rate increases. This can give you a greater understanding of potential costs.
If you are interested in purchasing a Medicare Supplemental Insurance Plan, look no further than Health Plans of NC. Our experienced team of agents can guide you toward a Medigap insurance provider that meets your unique needs. It is our goal to find the best plan for you.