Shopping for a Medicare Supplement Insurance Plan? Important Things to Know Before You Buy

While Medicare offers pretty good medical coverage, there’s a chance that it won’t cover all of your medical expenses. If there’s a gap in your coverage, you could end up paying a significant amount of money out of your own pocket.

Medicare Supplement (Medigap) Insurance is a private health insurance policy that covers the cost of any gaps in both Medicare Part A and Medicare Part B for physicians and hospitals. Medigap Insurance will give you peace of mind knowing that you won’t have to be burdened with the costs that result from gaps in healthcare coverage provided by Medicare. Therefore, if you have Medicare, it’s highly advisable to look into a Medigap Insurance policy.

If you’re shopping for a Medicare Supplement Policy, you probably have a few questions. To find out valuable information that will help you better understand this type of insurance, keep on reading.

What exactly does Medigap Insurance cover?

Medicare Supplement Insurance covers any medical procedure that is approved by Medicare and a Medicare provider, but isn’t covered by Medicare itself. If a procedure is not approved by Medicare, it probably won’t be covered by a Medigap Insurance policy. It also covers other costs that are not covered by Medicare, including co-payments and deductibles.

A Medigap Insurance policy does not cover vision, dental, or long-term care. It also won’t cover the cost of assistive devices, such as prescription eyeglasses and hearing aids. Additionally, the majority of plans will not cover the cost of prescription drugs.

Some companies that offer Medicare Supplement Insurance may offer provisions that will limit their liability for pre-existing medical conditions. However, if you had the “credible coverage” under a health plan that was sponsored by your employer or another Medigap policy, this limitation will not apply.

Am I eligible for Medicare Supplement Insurance?

If you are covered by either Medicare Part A or Medicare Part B, you are eligible for Medigap Insurance coverage. It is important to note that companies that offer Medicare Supplement Insurance do reserve the right to set additional criteria for qualification of coverage that extend beyond Medicare eligibility; however, anyone who is on Open Enrollment or has a Guaranteed Issue cannot be excluded.

What type of Medicare Supplement plans are available?

In most states, there are 10 Medigap plans available. Each plan is differentiated by a letter, and that letter indicates the level of coverage plans offer. Typically, Medicare Supplement plans offer the same standardized coverage for each category; for example, every insurance provider that sells Plan A offers the same coverage. All companies that offer Medigap insurance must offer Plan A, but beyond that, it is up to each company’s discretion to decide which policies they offer.

When can I purchase Medicare Supplement Insurance?

The open enrollment period for Medigap Insurance is 6 months from the first day of the month of your 65th birthday, but you must be signed up for Medicare Part B. You can also purchase insurance up to 6 months after you sign up for Medicare Part B.

During open enrollment, you can purchase any Medicare Supplement Insurance policy. If you wait until after the open enrollment period, you are not guaranteed to receive coverage. And, if you do receive coverage, the rates for your Medigap coverage may be higher.

Are there any pricing differences that I need to be aware of?

Rates for Medicare Supplement Insurance plans vary. Different providers can charge different rates, and different supplemental plans have different prices. Also, the area in which you reside can affect the rates. The pricing for Medigap Insurance plans is not standardized. In other words, one company could charge significantly more than another, which is why it is important to shop around to find the best rate.

Are there restrictions on physicians and hospitals?

There are no limitations regarding the doctors or hospitals you use, and there aren’t any restrictive networks. As long as you have a Medigap Insurance policy, any provider that accepts Medicare will accept your policy, and your supplemental insurance will pay the provider.

What is the claims process like?

The claims process for Medigap Insurance is very simple. All claims are filed electronically and come directly from Medicare. Medicare will automatically send a copy of your claim and how it was paid directly to your Medicare Supplement Insurance provider. Your provider will use this information to determine how they will pay your claim. This means that there is no need for you or your physician to file an additional claim.

If you are covered by Medicare, it’s highly advisable to purchase a Medigap Insurance policy. You’ll have greater peace of mind and could save a tremendous of money with this additional coverage.