Understanding Medicare Supplement Insurance
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Medicare supplement insurance is also called Medigap supplemental insurance. It's basically a private health insurance policy that supplements "gaps" in Medicare benefits. For example, Medicare doesn't cover co-payments, deductibles or coinsurance. Medigap does. Medigap policies cover various healthcare services that Medicare doesn't cover. For individuals who already have Medicare insurance and a Medigap policy, Medicare pays for approved amounts first, and then Medigap picks up a portion of the rest. However, be advised that Medicare does not pay for Medigap policies.
Medigap policies follow federal and state laws, and should be clearly defined as Medicare supplement insurance. Medigap supplement insurance policies are identified with letters A through L. Regardless of what type of California Health Insurance Company sells Medigap policies, they all contain basic benefits. Costs of various Medigap policies may differ according to different insurance companies.
Medigap policies A through L may help pay coinsurance costs, as well as co-payments. They also pay for blood used in blood transfusions and during surgical procedures, though most individuals are required to pay for the first 3 pints of blood. Medigap policies may also help pay for skilled nursing facility care coinsurance as well as hospice care coinsurance and co-payments. Some Medigap plans also help cover costs of Medicare Part A deductibles as well as Part B deductibles.
Medigap plans C, E, D, E, F, G, H, I, or J. may help pay for domestic or foreign travel emergency care. Medigap plans may also pay for preventative care as well as Part B coinsurance costs for preventative care. Medicare alone does not cover preventative care, which makes owning a Medigap policy a very smart move for many seniors.
Individuals should realize that Medigap policies don't cover long-term care, such as that found in nursing home, or private duty nursing, hearing aids, eyeglasses, or vision or dental care. Medigap policies are not the same as and do not include Medicare Advantage Plans (Part C) such as HMOs, PPOs, or private fee-for-service plans. Medigap does not cover Medicare prescription drug plans (Part D) or Medicaid. Medigap insurance is not not long-term care insurance, nor is it veteran’s benefits or military benefits. It does not cover Indian health service or health plans.
Your California health insurance agent can help you with standardized Medigap policies. Some insurance companies don't offer every Medigap policy, but they must offer Medigap Plan A if they offer any other Medigap policy. Basically, each insurance agency or company decides which type of Medigap policies it chooses to sell, or must follow state guidelines and laws that affect which ones they are able to offer.
When purchasing a Medigap policy remember that you must have Medicare part A and Part B. You pay premiums for Medigap policies in addition to the monthly Part B premiums that are paid to Medicare. Medigap only pays coinsurance after deductibles have been met unless the Medigap policy also covers this deductible. Medigap policies only cover one individual, so if you and a spouse want Medigap coverage, you must both purchased separate Medigap policies.
Standardized Medigap policies are guaranteed renewable even if you have health problems, meaning that insurance companies are unable to cancel your Medigap policy as long as premiums are paid.
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