You just turned 65 and have no idea where you can go to begin learning about Medicare? In addition, you keep hearing about Medigap, but what is Medigap insurance and do you need it?

These questions are driving your to-do-list. To help answer those questions, you will find an informational guide on Medicare and Medigap insurance listed below. Medigap insurance is also known as the Medicare Supplemental Plan.

Once you read through the informational guide below, you should be able to decide if a Medicare Supplemental plan is right for you.


What is Medigap Conditions?

Medigap is a Medicare Supplemental Insurance. It was created to help pay part of your health care costs that Medicare didn’t cover. Some of the items Medigap pays for is:

  • Deductibles
  • Co-Insurance
  • Co-Payments, and more

There are conditions for obtaining Medigap insurance. The conditions are:

  • You are age 65
  • You are enrolled in Medicare Parts A and B

The conditions are mandatory, but if you are disabled and under the age of 65, you can purchase Medigap Insurance if you qualify. The plans below offer coverage that is guaranteed if you enroll in the first six months of the open enrollment period (OEP).

You can purchase one of these plans during this OEP period without underwriting.


What is Medigap Insurance?

Medigap is unique because it is offered through private insurance providers. It is required that you pay a monthly premium for Medicare Part B. It is important to understand Medicare Supplement plans have costs and benefits that depend on which Medigap plan you select.

What is Medigap Plan Choices?

The Medigap plan choices are varied and diverse in the coverage they offer you. You must weigh each one’s unique coverage to determine the one that best fits your needs.

Plan A

Plan A is the basic Medigap plan with copayments. Plan A covers 20% on outpatient treatment. The benefits for services offered are listed under Medicare Parts A and B.

If you aren’t 65 yet, your cost for Plan A is three times more than someone who is 65 or older.

Plan B

Plan B offers the same benefits as Plan A. It also covers Medicare Part A hospital deductible and pays the deductible several times in the same year, if needed.

Plan C

Plan C is often confused with Medicare Part C. Medigap Plan C provides the same coverage as plans A and B. Plan C doesn’t cover any Medicare excess charges.

The problem with not covering excess charges is these charges can go 15% over what Medicare will cover.

Plan D

Plan D is intended to cover the gaps in Medicare coverage. It includes 20% outpatient charges but doesn’t cover any of your deductibles. Plan D also doesn’t cover any of the Medicare excess charges we listed in Plan C.

Plan F

If there is a gold standard for Medigap Plan, it is Plan F. Plan F is the most comprehensive Medigap plan and covers deductibles and copays. It also covers almost all out of pocket costs you have for medical expenses offered in Medicare Supplemental insurance.

If you switch your Plan F insurance carrier, you have to go through the underwriting process. Plan F is also the only plan to offer a High Deductible version, which includes very low monthly premiums. The low monthly premiums are combined with unique protection.

The unique protection guards you against high out-of-pocket costs set every year by the IRS.


Plan G

Plan G is adequate Medigap insurance because it covers everything that Plan F does except for one thing. Plan G doesn’t cover the Part B deductible. If you pay off your Part B deductible, you get most of the benefits of Plan F’s coverage.

Plan K

Plan K offers you lower monthly premiums. By paying lower premiums every month, you have a higher cost-share with insurance companies. You also have to pay Parts A and B deductibles, but you can qualify for an extra year in the hospital if you need it.

Unique Plan K Supplemental Insurance

There is unique supplemental insurance for Plan K that caps out-of-pocket charges. The cap is set around $4,960 per year. Your Plan K insurance kicks in after that and covers any other expenses for the year.

This supplemental Plan K also pays for your preventative care services.

Plan L

Plan L allows you to reduce your premiums up to 75% for the medical expenses covered by your insurance carrier. In exchange, you have to pay Medicare Part B deductibles and surcharges.

Plan M

Plan M covers the basic medical expenses the other supplements offer. You also get to pay lower monthly premiums. In return for the lower monthly premiums, you have to pay the entire amount of your outpatient deductible.

You also have to pay half of your hospital deductible.

Plan N

Plan N is another low monthly premium insurance plan. Plan N covers 20% of what Medicare doesn’t pay in hospital deductibles, co-pays, and co-insurance fees. Plan N makes you share costs with your insurance company for your doctor co-pays and any Emergency Room visits.

It is at this point, most people want to know how to buy Medigap insurance?

When Can You Buy Medigap Insurance?

Medigap plans are offered during your 6-month Medigap open enrollment period. In Florida and elsewhere, you can purchase a Medigap plan regardless of your health or previous health issues.

You have to be already enrolled in Medicare Part B. Medicare Part B covers medical expenses like doctor office services, outpatient, medical supplies, and any preventive medical services you receive. It’s important to know after the enrollment period you may not be able to buy Medigap insurance or if you do want to purchase, it will cost more.

What is the Medigap Insurance Process?

The process for Medigap insurance commencement is quite simple. Let’s say you already have Medicare and you purchase one of the Medigap plans listed above. At the time you go in for medical treatment, a two-step process occurs.

The first step is your Medicare coverage approves your share of the amount you owe for your healthcare expenses. Then the healthcare expenses left which your Medicare coverage did not pay, go to your Medigap insurance plan.

Your Medigap insurance pays its part, and then you receive the rest of the bill if any payment amount remains.

What Do You Need to do Next?

Do you now know the answer to what is Medigap insurance? We hope so because deciding which Medigap plan you want depends on the quality of health you want to strive for during your retirement and twilight years. Don’t get confused about any unknowns with Medigap Insurance.

We are standing by to give you the answers, information, and expert services to best determine which plan meets your health care needs.

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