Important Information About Medigap

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understanding changes in health insurance

The rules, regulations and restrictions of medical insurance can change a lot over short periods of time. What may be covered this year may not be next year. The premiums that you are paying this year could double next year. How much do you pay out of pocket before your insurance picks up the expenses? Do you have an out of pocket limit to meet before your insurance covers anything? Our blog will help you gain a better understanding of how your insurance works to protect you and assistance in reading the documents you receive to alert you of upcoming changes on your health insurance policy.

Important Information About Medigap

31 March 2017
 Categories: , Blog

Medigap can be confusing because it's one of many Medicare-related health plans. Most people who aren't on Medicare think of it as one monolithic policy, but it's not. Traditional Medicare covers a certain amount, and after that, you have to rely on another policy. For those who enrolled in traditional Medicare, Medigap is what you want -- and even that is divided into separate policies. There are additional things you need to know about Medigap depending on your age, when you signed up, where you signed up, and what other coverage you need.

Under 65

If you have just qualified for Medicare under the age of 65 because you have a disability, note that you might not be able to get Medigap. Some states do sell versions of Medigap to those under 65, unless they have end-stage renal (kidney) disease. However, if you're under 65 and in a state that doesn't sell them to people your age, you may have to look at additional supplemental policies. Once you turn 65, though, enroll in Medigap within six months.

Medicare Advantage

You can't switch between Medicare Advantage and Medigap. The two are mutually exclusive and depend on when you enrolled in Medicare. If, for some reason, you decided not to enroll in traditional Medicare within the grace period, Medicare Advantage is your only choice. However, that plan does combine a lot of the coverage that the lettered Medigap plans provide separately.

Peripheral Policies and Prescriptions

Medigap plans don't cover additional health categories like vision, and you need a separate Medigap policy for prescription coverage. When you sign up for traditional Medicare, also look at each lettered Medigap plan to see what additional costs it covers. You don't want to be left with a gaping hole in your coverage (that is, after all, why they call it Medigap, because it covers that gap left by traditional Medicare)

State Standardization

Medigap policies are supposed to be standardized across states; however, Minnesota, Wisconsin, and Massachusetts offer a different standardization. If you plan to move to or from one of these states, you'll need to double-check what your Medigap plans cover in the new state. You shouldn't see a huge difference, but you might see enough so that you can't assume that your new plan will cover what you think it does.

The insurance broker or Medicare signup assistant you deal with should be able to give you more information on what you need in your specific situation. However, before you contact them, always write up a list of coverages you want and questions you have. The more information you get now, the easier it will be to sign up for and use Medigap. Contact a company like Senior Advisors to learn more.