Tuesday, September 18, 2012

The Basics of Medicare and Medigap Insurance

Medicare originally is understood to be Part A, which is hospital insurance and Part B, which is medical insurance.  This original coverage allows for many but not every medical or health related service and supply.  There is insurance available, called Medigap or Medicare Supplemental Insurance that covers expenses that are not covered under the general Medicare Part A and Part B. 

This includes things such as copayments, coinsurances, deductibles and expenses when traveling outside of the United States.  Believe it or not the out of pocket expenses can add up very quickly and before you know it you could have easily paid the monthly premium of a Medicare Supplement Plan.

Many Medicare participants don’t understand exactly how Medicare and Medigap work together.  First it should be understood that when you do choose a Medigap policy, Medicare will still pay their approved share upfront and then the Medigap policy pays its share of the cost.  

It is best to understand that Medigap policies are sold by private insurance companies. The policy itself is the same no matter who sells it however the cost to participants might change. When you buy Medigap Plan G at one insurance company is the exact same coverage you will receive through another insurance company. The difference being the premium you pay them to offer you the insurance. This is one of the reasons it is so important to do research before settling on a Medigap plan and provider. 

Each plan covers a variety of services to their participants. Below is a list of options you should look for when choosing a Medigap policy to suit your diverse needs.

·         Inpatient Hospital Care: This piece will cover the coinsurance for Medicare Part A not the deductible though.
·         Medical Costs: This piece will cover the coinsurance for Medicare Part B and copayments for hospital outpatient services. This can save a lot of money as the coinsurance amount left from Part B is twenty percent of the Medicare approved amount.
·         Blood: Believe it or not without a Medigap policy, blood is not covered.  The right Medigap policy will cover the first three pints of blood you need each year.
Other benefits that are included in Medigap Policies can include a variety of services some of which are in the list below.
·         The annual hospital deductible
·         Coinsurance for skilled nursing facilities
·         The annual deductible for Medicare Part B
·         During travel abroad emergency care coverage
·         Recovery at home
·         Care not covered by Medicare
·         Excess charges from the doctor above and beyond the pre-approved Medicare amount

If you are enrolled in the Medicare Advantage Plan you will not purchase Medigap insurance. It is unnecessary as the items covered by the Medicare Advantage Plan are equivalent to the items covered within MedicareSupplemental Insurance.   If you would like more information on Medicare and Supplemental Insurance a great online resource is run through the government although you are not able to purchase Medigap policies directly through the government. To purchase a policy it is best to research insurance providers in your area that offer Medigap insurance.

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