What is Medigap Insurance, anyways? It is very common to get confused between Medicare, Medicare Supplements and Medigap.
When you finish this 2 minute article you will have a much better understanding of the basics of Medigap insurance.
We will review the most common questions associated with Medigap insurance, such as; ‘What is Medigap Insurance?’, ‘What Is Medigap Plan F?’, and ‘How Much Does Medigap Cost?’.
Medigap Insurance is private health insurance that covers the ‘gap’ between what Medicare Part A and Part B insurance includes with Medigap Plans covering the difference.
Medicare only covers a portion of your hospital and doctors’ visits.
You will be responsible for paying for what Medicare does not if you do not have Medigap Insurance, Medicare Supplements, Medicare Advantage or another supplemental health insurance program.
Whether your Medigap Insurance plan will include all those benefits will depend on the plan you choose.
The word Medigap is just another word for Medicare Supplement Plans, Med Sups, Medicare Supplements and Supplement Plans.
I know it can be confusing when you read one term used and then another in the same article.
Understand that they all are referring to the ten Medigap plans that are offered to supplement your out-of-pocket Medicare insurance costs.
Medigap is a private insurance regulated by the government to provide additional medical coverage for hospital and doctors’ visits.
Medicare only covers a percentage of your medical costs and Medigap insurance can cover some or all of the additional costs.
The amount that the Medigap plan will cover is different from plan to plan.
Some plans only cover a small portion of the ‘gap’ while others will almost cover everything.
Medigap Plan F aka Medicare Supplement Plan F has been the top choice of Seniors for many years.
However, congress voted for the plan to be discontinued effective at the end of 2019.
Medigap Plan F was the Cadillac of the Medicare Supplement plans offering complete gap coverage and even paying both your Medicare Part A and Part B premiums.
Which is where it got into problems, it was determined that because Medigap Plan F included the payment for Medicare Part B (doctors’ visits) people would make appointments to see their doctor for minor ailments because it cost them nothing.
What the government study found was that when a Plan F member made an appointment for something minor and it went away on its own, they wouldn’t cancel their upcoming doctors’ appointment.
Or they would go and see the doctor for very minor things that usually a doctor would not be consulted upon.
It was determined that by doing away with this plan, this problem would stop and the costs relative to all the remaining plans would be better aligned.
| BENEFITS | PLAN N | PLAN G | PLAN F |
|---|---|---|---|
| Part A HospitalCo-Insurance | YES | YES | YES |
| 365 Hospital Reserve Days | YES | YES | YES |
| Part B Co-Insurance /Co-Payment | YES | YES | YES |
| Blood Benefit(First 3 Pints) | YES | YES | YES |
| HospiceCo-Insurance /Co-Payment | YES | YES | YES |
| Skilled Nursing Facility Co-Insurance | YES | YES | YES |
| Part A Deductible | YES | YES | YES |
| Part B Deductible | NO | NO | YES |
| Part BExcess Charge | NO | YES | YES |
| ForeignTravel Benefit | 80% | 80% | 80% |
| Out Of Pocket Limit | N/A | N/A | N/A |
The cost for Medigap coverage is regulated by each States insurance agency. There can be quite a large premium difference between each carriers Medigap plans, so it is wise to work with an advisor who has access to at least the top 5 lowest priced plans in your state. While Aetna may be very competitive in one state, Heartland National may be more competitive in your state.
Medigap insurance is provided by private insurance companies but heavily regulated by the government.
There are ten different Medigap plans that you can choose from, Plans A, B, D, F, G, K, L, M, N.
Each plan offers different combinations of benefits.
The costs of each plan are different and the costs also are different based on where you live.
Contact a Senior Benefits Medigap expert today to discuss your particular situation and get a free, no obligation, quote just for you.
Now that you have a much better understanding of What Is Medigap Insurance and what it covers, it’s time to discuss your situation with a Senior Benefit Services expert. You can reach us at (800)924-4727.
There is a limited time you are eligible to enroll during your one-time open enrollment period or the costs of Medicare Supplement coverage can increase dramatically.
Contact Senior Benefit Services today to find out what the best combination of coverage’s are for you.
Medigap is designed to cover the gaps that Original Medicare leaves behind.
Practically speaking, Medicare only pays a portion of your medical bills. What’s left over can add up quickly, especially with that 20% Part B coinsurance that has no cap.
Based on the plan you choose, Medigap can help cover things like hospital deductibles, doctor visit coinsurance, skilled nursing costs, and even excess charges in some scenarios.
The clean way to think about it is this: Medigap turns unpredictable medical bills into something much more predictable. That’s why we recommend it for folks who want stability and fewer financial surprises.
The cost of Medigap can vary quite a bit depending on your age, location, and the plan you select.
For example, someone in Arkansas might see very different pricing than someone in Maryland, even for the exact same plan. That’s because rates are set by private insurance companies and regulated at the state level.
Here’s the important part most people miss:
The coverage for each plan letter is standardized, but the price is not.
So in one scenario, you could pay significantly more for the exact same benefits if you don’t compare multiple carriers. That’s why working with someone who can shop several companies at once can make a big difference.
Bottom line: you’re trading a monthly premium for protection against much larger, unpredictable expenses.
This is where a lot of confusion happens, so let’s make it simple.
Medicare is your primary health insurance provided by the government. It covers hospital stays and doctor visits, but only up to a certain point.
Medigap is secondary insurance from a private company that helps pay what Medicare does not cover.
Think of it like this:
Medicare pays first.
Medigap helps cover the rest.
Without Medigap (or another type of coverage), you are responsible for those leftover costs. And in some cases, that can turn into a financial disaster pretty quickly if something major happens.
That’s why understanding how these two work together is so important when building a plan that fits your budget and your comfort level.
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