MEDICARE

What is Medigap and how is it different from Medicare?

When choosing what kind of plan they want, those eligible to participate in Medicare can purchase additional health insurance to get extra coverage.

Every year, adults age 65 and over, as well as other eligible individuals with specific medical conditions or disabilities can sign up for or change their Medicare plans during the Open Enrollment period. It runs for just over seven weeks from 15 October through 7 December.

Medicare has offered health insurance programs for more than five decades which now consists of four different plans. They are known as Parts A, B, C and D, which cover different needs of beneficiaries.

Part A covers hospital and hospice care, as well as some skilled nursing services. Part B includes doctor visits, diagnostic tests, and other services outside the hospital.

Part C, also known as Medicare Advantage, is purchased from private healthcare providers which may include benefits like vision and dental, which are not included in a standard Medicare plan. These plans combine Part A, Part B, and the fourth, Part D, which helps pay for prescription drugs.

In addition to these plans, there is Medicare supplement insurance called Medigap. Below is an explanation of what it consists of and what benefits it offers.

Medigap: What is Medicare supplement insurance and what benefits does it have?

According to the Medicare website, Medicare Supplement Insurance or Medigap is additional insurance that you can buy from a private health insurance company to help pay your share of out-of-pocket costs in Original Medicare.

You can only buy Medigap if you have Original Medicare. That means you have to enroll in both Part A and Part B. According to the Medicare website, a person gets a Medigap Open Enrollment Period of six months, which begins the first month you have Medicare Part B and you are age 65 or older.

During this time, you can enroll in any Medigap policy and the insurance company can’t deny you coverage because of pre-existing health problems. After this period, you may not be able to buy a Medigap policy, or it may cost more.

Medigap benefits

Medigap policies help cover the out-of-pocket costs associated with Original Medicare, such as the following:

  • Copays
  • Coinsurance
  • Deductibles

Some Medigap policies also cover services that Original Medicare doesn't, such as emergency medical care when you travel outside the United States.

Medigap plans generally do not cover the following:

  • Long-term care (such as in a nursing home)
  • Visual or dental care
  • Hearing aids
  • Glasses
  • Private Duty Nursing Services

Also, Medigap plans sold after 2005 don’t include prescription drug coverage. You can get this benefit by joining another Medicare drug plan (Part D).

You can review a comparative table of the benefits offered by the different Medigap plans. on their website. For more information, visit the official Medicare website or call 1-800-MEDICARE (1-800-633-4227).

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