Our health care needs often become more significant as we age, and having the right health insurance coverage for the future is an understandable concern. Medicare offers valuable health coverage for eligible seniors, and that’s a big relief for many. However, the reality is that original Medicare may not cover all your medical expenses, and you’ll likely be responsible for various out-of-pocket costs over time.
Many people opt for Medigap plans to address these “gaps” in Medicare coverage. But is that kind of supplemental plan right for you? Below, let’s talk about what Medigap is and how it might complement your Medicare coverage in the years to come.
Benefits of Medigap
The federal government offers original Medicare (Part A and Part B), and it covers a substantial portion of hospital and medical costs for eligible individuals aged 65 and older. However, it still requires that you pay certain deductibles, copayments, and coinsurance out of your own pocket.
Medigap, also known as Medicare Supplement Insurance, is a private health insurance policy designed to help fill in the "gaps" left by original Medicare. Medigap plans are regulated by federal and state laws to ensure standardized coverage, and they work alongside your original Medicare.
Medigap plans are labeled with letters, from Plan A to Plan N. Each plan offers different levels of coverage, but not all companies offer all plan types in all states. This is why it’s crucial that you compare the Medigap plans available to you and choose the one that best meets your health care needs and financial situation.
Now, with all the above in mind, here are some of the key benefits of Medigap policies.
1. Increased Coverage
Medigap plans offer extended coverage for copayments, coinsurance, and deductibles, depending on the specific plan chosen. That extended coverage reduces your out-of-pocket expenses for medical services, giving you more financial predictability and better protection against unexpected medical costs.
2. Freedom to Choose Providers
Unlike some supplemental plans, Medigap allows you to visit any health care provider that accepts Medicare patients. This gives you the flexibility to access a wider network of doctors and specialists.
3. Nationwide Coverage
Medigap plans offer coverage across the United States, which is helpful if you travel frequently or reside in multiple states during the year. However, Medigap plans can vary by state, and you’ll want to carefully review the Medigap options available to you to make sure you’re getting the coverage you expect.
4. No Referral Requirement
Medigap plans do not require referrals to see specialists. You can seek specialized care without having to go through your primary care physician.
5. Guaranteed Renewal
As long as you pay your premiums on time, Medigap policies are guaranteed to be renewable. This means your coverage cannot be canceled due to health conditions or other factors as long as the policy remains in effect.
Open Enrollment Period for Medigap Policies
The best time to enroll in a Medigap plan is during the initial Medigap Open Enrollment Period. During this one-time enrollment period, insurance companies are not allowed to deny coverage or charge higher premiums based on pre-existing conditions.
If you wait until after your Medigap Open Enrollment Period expires, the same supplemental plans may be more expensive or unavailable to you.
You should also keep in mind that Medigap policies only cover one person per plan. You must purchase separate policies if you and your spouse want Medigap coverage.