Further Understanding Medigap Coverage

For everyone 65 or older, preferably those who have just turned 65, taking advantage of Medigap coverage is an option one must consider.  This is because Medigap fills in the gaps that your original Medicare Plan does not cover.  It is very easy to get covered by Medigap, as it is readily available through private insurance carriers, and there is no question about the added security and long-term savings Medigap coverage can offer, but there are some things you would need to know before going any further.

Medigap policies currently come in twelve different types of coverage ranging from A to L.  However, changes to the structure of Medigap coverage will eventually bring that number down to ten, as plans E, H, I and J are retired and plans M and N introduced.  Prior to the introduction of plans M and N, plans K and L were introduced in 2005, so who knows?  There just may be some additional plans added in coming years.  Just the same, all this applies for all states except Massachusetts, Minnesota and Wisconsin.  Federal law mandates that each Medigap plan have the exact same features and benefits for every insurance provider, though premiums may vary depending on the provider.  Insurance providers are not required to offer all plans, so if you’re looking for a specific level of Medigap coverage, shopping around for the right provider is essential.

Purchasing a Medigap plan means that your premiums go directly to the insurance provider, while you continue to pay your Medicare Part B premiums.  As long as these premiums are paid, any Medigap policy purchased after 1990 is renewed automatically for added convenience.  For those with Medigap policies purchased before 1990, some states have carriers that refuse to renew Medigap plans and would require you to purchase a new one.  This is a legal practice in those states, and it may be better in the long run to purchase a new policy anyway.

Medigap policies do not work if you are already a member of an existing Medicare Advantage Plan or other Medicare plans – these would be the only instances where we believe it would not be necessary to get a Medigap policy.  There are, in fact, laws that prohibit insurance providers from selling Medigap policies in these circumstances.  It would be illegal for a provider to sell you Medigap coverage if you are a member of a Medicare Advantage Plan not due to expire, if you already own a Medigap policy and are not about to cancel, or are a Medicaid member, unless Medicaid pays for the Medigap premiums or your Part B premium.

Once you already have a Medigap policy, any health service, hospital or doctor that accepts Medicare will be more than willing to accommodate you.  In some cases, though, you may need to visit only specific hospitals or doctors that support your Medigap plan.  This would be, specifically, if you are a member of Medicare SELECT.  Other than that, having Medigap allows for a lot of convenience and flexibility, and at the end of the day, is money well spent.

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