Medicare is the federal health insurance program for people over the age of 65, certain younger adults with disabilities and people suffering from End-Stage Renal Disease. There are three tiers of Medicare that insure different services. However, not all medical expenses are covered by Medicare, which is where Medigap fits in. Medigap helps to fill “gaps” in Medicare and is sold by private companies. Below we discuss the different Medicare plans, as well as what you should know about Medigap policies.
Medicare Part A
Medicare Part A covers inpatient hospital care, skilled nursing facility care, short-term nursing home care, hospice care and home health care. In general, most people receive premium-free Part A depending on the amount of time that the individual or a spouse paid Medicare taxes while working.
Medicare Part B
Medicare Part B insures services or necessities essential to diagnosing or treating a medical condition that satisfy established standards of medical practice. In addition, Medicare Part B also insures health care that prevents illnesses or detects early diagnosis where the treatment is most effective. Part B also insures clinical research, ambulance services, durable medical equipment, inpatient and outpatient mental health services, partial hospitalization and particular outpatient prescription drugs.
Medicare Part D
Medicare Part D includes coverage for outpatient prescription drugs. Part D Medicare covers the prescription drugs that are not covered by Part A or Part B. Medicare Part D plans are offered through private insurance companies as stand-alone, but in order to be eligible you must be enrolled in Medicare Part A or Part B.
Medigap
Medigap, also known as Medicare Supplement Insurance, provides assistance in covering the services that are not insured in Medicare Part A or Part B. To be eligible for Medigap, you must have Medicare Part A and Part B. Medigap can assist in paying for copays, coinsurance and deductibles. Medigap also covers medical care when traveling internationally. The purpose of Medigap is to suffice for the services not covered by Medicare. Medigap is accepted by any doctor or practitioner that accepts Medicare.
Since Medigap is sold by private insurance companies, you pay them a monthly premium for your Medigap policy, as well as the monthly premium you pay for Medicare Part B. Medigap only insures one person, so if your spouse is also interested in Medigap, they will want to purchase their own policy.
Medigap is available from any insurance company that’s licensed to offer them in your state. Even if you have health issues, any standardized Medigap coverage is guaranteed to renew. This implies that as long as you pay your premiums, the insurance provider cannot terminate your Medigap policy.
Medigap is unavailable to anyone who has a Medicare Advantage plan. However, during open enrollment, individuals who have a Medicare Advantage plan can replace their plans with no underwriting. Long-term care, vision or dental treatment, hearing aids, eyeglasses, or private-duty nursing are typically not covered by Medigap insurance.
Consult With a Medicare Supplemental Insurance Agent at Unity Insurance Today
Choosing a Medigap Policy may be complex, consulting a qualified and experienced insurance agent at Unity Insurance can provide you with the guidance and support in purchasing a Medigap Policy. Our Medigap specialists can walk you through plans that are available to you as well as help you determine which route you should take. To consult with a member of our team, contact us today.