Medical Insurance is an essential part of an average person’s life. Statistically, every 9 in 100 American Adults are uninsured, which is alarming, but that’s for another day. Most insured American seniors get coverage through Medicare, a government-based health insurance system for adults over 65. Original Medicare has two initial subsets: Medicare Part A (for hospital insurance) and Medicare Part B (for medical insurance).

Even though Medicare Part A and Part B are convenient, cost-effective, and helpful, there are certain services that Original Medicare doesn’t provide coverage for. To counter this problem, private insurance agencies all over the US have developed Medicare-approved insurance plans. These plans are known as Medicare supplemental insurance coverage or Medigap.

What is Medicare Supplemental Insurance Coverage?

Medicare Supplemental Insurance Coverage plan or Medigap is essentially an insurance plan to cover the areas that the Original Medicare (Part A and Part B) insurance coverage does not. Medicare Supplemental Insurance Coverage helps pay other insurance costs like deductibles, copayments, and coinsurance.

What are Deductibles and Copayments?

The amount you pay from your pocket before the insurance plan starts to pay is known as deductibles. Deductibles are essentially paid to kickstart your insurance and avoid small claims.

After you have paid the amount of the deductibles, you only need to pay an amount known as a copayment. Copayments are a small fixed amount you must pay each time you avail of a service covered under your insurance plan.

What is Coinsurance?

Coinsurance is the division of risk among multiple parties in an insurance plan. It is the fraction of the cost you pay for a service you avail of after the deductible amount is paid.

Why is it important for seniors to consider Medicare Supplemental insurance coverage?

Even though original Medicare insurance covers a lot, to some extent, it may not be as efficient as you would want it to be. There might be some services you pay for but rarely or never use, or there might be a service you may need in the future, but your insurance plan does not cover it. To handle this issue, a top-quality private insurance agency will find you a customized Medicare Supplemental insurance coverage plan that fits your needs while omitting features you don’t need.

Also, if you, unfortunately, suffer from an ailment that requires specific treatment or care not covered by your original Medicare plan.  That treatment would prove to be very

 heavy on your pocket and your heart(metaphorically). Therefore, if you are a senior, you must find an insurance consultancy agent who will own your requirements and give you a cost-effective and efficient solution.

Things to know before considering Medicare Supplemental Insurance Coverage

To get Medicare Supplemental Insurance Coverage or Medigap, you must have an original Medicare plan (Part A and B). Medigap differs from Medicare Advantage Plan; while Medigap further covers the benefits of actual Medicare insurance, Medicare Advantage plans are one way to get Medicare insurance.

For the Medigap policy, you pay the insurance company a monthly fee in addition to the payment you are bound to pay to Medicare insurance initially. One Medigap policy is eligible for one person only, and another must be bought if your spouse also needs one.

There is no restriction on which insurance company you can choose as long as they are legally allowed to sell one in your state. If you have a Medicare Advantage plan, you can’t buy a Medicare supplement insurance program; it’s against the law for someone in the US to sell you a Medigap plan until you switch from Medigap to the stock one.

Cons of having Medigap

Medigap policies don’t offer Medicare part D (drug prescription coverage), so they must be bought separately. However, if you have a drug prescription plan purchased before January 1st, 2006, you can keep it.

Another disadvantage is that you don’t get everything covered with Medigap. Many services include skilled private nursing, long-term care, dental, medical services, vision services, hearing aids, and spectacles.

Types of Medicare Supplemental Insurance Coverage

There are many choices if you want to find Medicare supplemental Insurance as a senior. Here are the ten standardized options for choosing a Medicare Supplemental Insurance Coverage (Medigap) plan.

Medigap Plan A

Medigap Plan A covers the expenses you pay out-of-pocket in your original Medicare Part A and Part B. Medigap Plan A is a primary plan covering what every other Medigap plan does. Plan A includes coinsurance costs for the Medicare hospital insurance plan and covers hospital costs up to 365 after your Medicare benefits are availed. Plan A also covers Medicare part B coinsurance or copayment and coinsurance for hospice care for Medicare Part A.

Medigap Plan B

Medigap Plan B’s coverage includes services that Medigap plan A covers, along with the coverage of deductibles in Medicare Part A (Medicare part A coinsurance, Medicare part B coinsurance/copayment, hospice care coinsurance, Part A deductibles).

Medigap Plan C

The services covered in Medigap Plan C include all the services that Medigap plan B covers, including coinsurance payments for skilled nurse care services and deductibles for part B. Up to 80% of foreign travel emergency costs are included, depending upon the plan (Medicare part A coinsurance, Medicare part B coinsurance/copayment, hospice care coinsurance, skilled nursing care facility coinsurance, Part A deductibles, Part B deductibles, 80% foreign travel emergency).

Medigap Plan D

Medigap Plan D and Medigap Plan C differ because Medigap Plan D does not cover Medicare part B deductibles. Everything else in Medigap Plan D is similar to Plan C (Medicare part A coinsurance. Medicare part B coinsurance/copayment, hospice care coinsurance, skilled nursing care facility coinsurance, 80% foreign travel emergency, and Part A deductibles) are also included in the plan D.

Medigap Plan F

Medigap Plan F provides the most coverage among all plans. Plan F includes everything Plan C offers, along with Part B excess charges (Medicare part A coinsurance, Medicare part B coinsurance/copayment, hospice care coinsurance, skilled nursing care facility coinsurance, Part A deductibles, Part B deductibles, 80% foreign travel emergency, and Part B excess charge).

Medigap Plan G

Medigap part G covers all that plan F does, except part B deductibles (Medicare part A coinsurance, Medicare part B coinsurance/copayment, hospice care coinsurance, skilled nursing care facility coinsurance, Part A deductibles, 80% foreign travel emergency, and Part B excess charge).

Medigap Plan K

Coverage of Medigap Plan K contains coinsurance and hospital costs for Medicare part A, 50% coverage of Medicare part A copayments, blood transfusions, Part A hospice care coinsurance/copayment, coinsurance for skilled nursing care, and Part A deductible.

Medigap Plan L

The coverage of Medigap plan L has Part A’s hospital costs, coinsurance, 75% coverage of Medicare, Part A copayments, blood transfusions, Part A hospice care coinsurance/copayment, coinsurance for skilled nursing care, and Part A deductible.

Medigap Plan M

Medigap Plan M and Plan D are the same, but Plan M only covers 50% of Part A deductible, while Part D covers 100%. The total coverage of Medigap Plan M includes the following:

  • Medicare part A coinsurance.
  • Medicare part B coinsurance/copayment.
  • Hospice care coinsurance.
  • Skilled nursing care facility coinsurance.
  • 80% foreign travel emergency.
  • 50% of Part A deductibles.

Medigap Plan N

Medigap Plan N is essentially plan G without Medicare part B excess charges (Medicare part A coinsurance, Medicare part B coinsurance/copayment, hospice care coinsurance, skilled nursing care facility coinsurance, Part A deductibles, and 80% foreign travel emergency).

Conclusion

It is very important to get a Medicare supplemental insurance coverage plan that covers what your original Medicare does not. If you are over 65, there are services you may need in the future that your original plan needs to cover. To ensure optimum coverage, you need to get a Medigap plan ASAP.