10 Things You Should Know About Medigap Insurance Plans Before You Turn 65

in medicare •  6 years ago 

Turning 65 brings you a different feeling. It is like you have hit a milestone or like there is an achievement that you have unlocked. Whatever mixed emotions you might feel as you turn 65, the most important thing is that you have reached this far in life. And in this phase, you will have another set of task to accomplish.

Most people who just turned 65 enroll in Original Medicare. That is Medicare Part A which covers hospital care, nursing home care, home health services, hospice, and skilled nursing facility care and Part B which cover outpatient services. As you turned 65, you should be aware of the coverage of your Medicare and know that there will be an out-of-pocket cost that you also need to share. Deductibles, copays and 20% of medical services, especially done in outpatient are some of those out-of-pocket costs that you will shoulder. There may be a point that these out-of-pocket expenses will be out of hand and challenging to handle. For that, Medicare beneficiaries often opt to get a Medigap Insurance plan (Medicare supplement plans) to help them with the out-of-pocket expenses brought about by Medicare.

Today, there are about 13.1 Million Medicare beneficiaries have Medigap insurance plans.

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What are the things that I need to know about Medigap insurance plans?

If you are interested to know more about this type of Medicare insurance policy, here are the ten basic things you should know for starters.

1. You must have both Medicare Part A and B


To enroll in Medigap, you must be 65 and above and have both Medicare Part A and B.

2. Medigap Enrollment Open Enrollment Period (Medigap EOP)


A crucial period to get a Medigap policy because it only comes only once in your lifetime.
It automatically runs once the two requirements above are met. The period usually runs only for 6 months that begins on the first day of the month that you turn 65.
During this period, insurance companies…
a. Cannot refuse to sell you any Medigap policy no matter what medical condition you have (pre-existing conditions) also known as Guaranteed Issue Rights.
b. Cannot charge you a higher premium because of your past or present condition.
c. Cannot delay the start of your coverage

3. There are 10 standardized Medigap plans


These plans are labelled in alphabet letters. Keep in mind that same letters offer the same benefit no matter what insurance company you get your policy. The cost varies across insurance companies.

4. Medigap plans are sold by Private insurance companies.


Shopping around and and obtaining Medigap quotes from different insurance companies will help you find the lowest rate of the type of plan you want.

5. All Medigap plans offer the basic benefits (50% or 100%)


All Medigap policies offer 100% or 50% of these benefits:
• Medicare Part A coinsurance
• Medicare Part b coinsurance or copayments
• Blood (first 3 pints)
• Part A hospice care coinsurance or copayments

6. You cannot have both Medigap and Medicare Advantage at the same time


You must leave either one of them.

7. Medicare Supplements do not cover these things


• Long term care coverage
• Vision care
• Dental care
• Hearing care
• Prescription drugs
• Premiums of other insurance, including Medicare Part B

8. Medigap is an individual plan


If you and your spouse both want to have Medigap coverage, both of you must have your own policy.

9. Medigap insurance plan providers have different rating systems


Private insurance companies have different rating systems that will determine how much your premium will be in the present and in the future. These are:
a. Community-rated
b. Issue-age-rated
c. Attained-age-rated
As you shop around for a Medigap, make sure that you will compare plans of the same type in different insurance companies.

10. Medigap plan is guaranteed renewable


As long as you pay your monthly premiums.

Out-of-pocket expenses brought about by Original Medicare can blow up uncontrollably overtime. As your healthcare demands increases, so are the money that you will need to pay for it. Before that happens, cover the gaps with a Medigap insurance plan. Get your free Medicare supplement quotes and let a licensed insurance agent help you for free now.

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