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Is Medigap the Missing Piece in Your Medicare Puzzle

Is Medigap the Missing Piece in Your Medicare Puzzle ?

Supplement – Not Replacement

Choosing a Medicare Supplement plan, also known as Medigap (two names for the same thing), means opting for additional coverage, not a replacement for Original Medicare.

To be eligible for a Medicare Supplement plan, you must first enroll in both Medicare Parts A and B. These form the core of your Medicare health insurance coverage. That coverage is provided to you at age 65 without any preexisting condition limitations.

Medigap Supplement plans come through a private insurance carrier. Medigap plans aren’t primary coverage. They’re optional supplemental, private health insurance coverage that you can choose to purchase or not.

With a Medigap Supplement, you’re going to stay on your Original Medicare, Part A and Part B. Part A and B are your primary insurance so that means you must keep paying that Part B premium to Medicare. Your trusty red, white, and blue card stays in play.

Exclusions Apply

When you pair Original Medicare with a Medigap plan, the rule is simple – if Medicare covers it, so does your Medigap Supplement plan. If Medicare doesn’t cover things like prescription drugs or dental neither will your Medigap Supplement plan. Its only job is to be a secondary on medical expenses.

Covering You, One at a Time

Medigap Supplement plans are designed to cover one person only, aligning with Medicare’s individual approach. So if you have a spouse, he or she will need his or her own policy. But keep an eye out for insurance carriers that offer household discounts.

Paying Up

Medigap plans have higher premiums than most Advantage plans, which are often zero-premium, but they pick up the tab on the back end.

The costs of Medigap Supplement plans can vary. A reasonable estimate for a Medigap Supplement Plan G is about $150 a month at the time of this writing. The actual amount depends on factors like your plan, location, age, and the carrier’s rate structure.

You will pay a monthly premium to a private insurance company for the Medigap Supplement policy. This is in addition to your monthly Medicare Part B premium. Don’t worry – your Social Security benefits won’t be touched for Medigap premiums. Unlike your Part B premiums, Medigap Supplement premiums will not be drafted from your Social Security benefits.

Seamless Renewals

Once you’re in, you’re in. No need to re-enroll yearly. Medigap Supplements are guaranteed renewable. As long as you keep those premiums flowing, your policy stays put. The insurance company won’t cancel unless you fall behind on payments, and most carriers insist on the convenience of a recurring draft from your bank account.

Claims Processing with Medigap

Medicare usually gives the nod to most claims. Original Medicare will be the primary insurance covering 80% of Medicare-approved amounts for healthcare services that are billed to them by doctors and hospitals, while your Medigap Supplement smoothly takes care of the rest.

If Medicare approves a claim, it will pay its share and then send the remainder to your Medigap insurer, which must also pay its share. Medicare will bill the Medigap Supplement carrier the remaining 20% to pay on your behalf.

Medigap keeps things hassle-free when it comes to claims. There’s no need to file claims with your Medigap Supplement. Minimal involvement on your part – maximum peace of mind.

Investing in Robust Coverage

Picture this – you pay a bit extra for a Medigap Supplement, and it’s totally worth it. You’re going to pay more, but you keep your right to go to any doctor or hospital that welcomes Original Medicare. What’s more, you’re shielded from a flood of bills.

Medigap picks up where Original Medicare leaves off, giving you strong coverage. This private insurance company is going to be your secondary to Medicare. It’s going to pay after Medicare on medical bills, so a helpful way to think about a Medigap Supplement plan is its main job is to cover that crucial 20% of the medical expenses that Medicare leaves behind. It’s the closest thing that money can buy to full medical coverage in the Medicare world.

Distinction from Advantage Plans

A Medigap Supplement isn’t to be confused with an Advantage plan. It’s not the same.

A Medigap Supplement isn’t a replacement – it’s the ultimate sidekick to Original Medicare Part A and B. In contrast, an Advantage plan provides an alternate route to get Part A and B benefits through a private insurance company, not the federal government. It’s a replacement.

You cannot have both a Medigap Supplement and an Advantage plan at the same time. They’re not combinable. It’s either a Medigap Supplement or an Advantage plan – pick your favorite dance partner. Mixing them is a no-go.

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