Selecting a Supplemental Medigap Plan

Original Medicare pays for many, but not all, health care services and supplies.

Medicare Supplement Insurance policies, sold by private companies, can help pay some of the health care costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles.

 

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Comparing Plans

Always compare the same plans over various companies.

For example compare the cost of "Plan A" from one company to "Plan A" from another

Disclaimer: Baby Boomer Helper does not benefit in any way if our visitors sign up with any site related to supplemental healthcare plans. We provide links and information only. Always consult a professional healthcare expert before purchasing any healthcare plan.


Supplemental (Medigap Coverage) Plans

Links to Plans That Cover What Medicare or Medicaid Don't

Supplemental Insurance Plans

A Medicare supplement (Medigap) insurance, sold by private companies, can help pay some of the health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles.

Some Medigap policies also offer coverage for services that Original Medicare doesn't cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share.

A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.

Every Medigap policy must follow federal and state laws designed to protect you, and it must be clearly identified as "Medicare Supplement Insurance." Insurance companies can sell you only a "standardized" policy identified in most states by letters A, B, C, D, F, G,K, L, M, N. (See Graph Below)

Medigap Plans

All policies offer the same basic benefits but some offer additional benefits, so you can choose which one meets your needs.

IMPORTANT: In Massachusetts, Minnesota, and Wisconsin, Medigap policies are standardized in a different way.

Medicare and You Book 2015Each insurance company decides which Medigap policies it wants to sell, although state laws might affect which ones they offer.

Insurance companies that sell Medigap policies:

  • Don't have to offer every Medigap plan
  • Must offer Medigap Plan A if they offer any Medigap policy
  • Must also offer Plan C or Plan F if they offer any plan

You'll find more information on page 91 of the "Medicare and You 2015" Book (above) that you received in the mail and you can start shopping.

If you don't have the "Medicare and You 2015" you can order or download it CLICK HERE.

 

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For more information

Who Pays First?

If you have Medicare and other health insurance or coverage, each type of coverage is called a "payer." When there's more than one payer, "coordination of benefits " rules decide which one pays first.

The "primary payer" pays what it owes on your bills first, and then sends the rest to the "secondary payer" to pay. In some cases, there may also be a third payer.

Paying "first" means paying the whole bill up to the limits of the coverage. It doesn't always mean the primary payer pays first in time. If the insurance company doesn't pay the claim promptly (usually within 120 days), your doctor or other provider may bill Medicare.

Medicare may make a conditional payment to pay the bill, and then later recover any payments the primary payer should've made.

If you have questions about who pays first, or if your insurance changes, call the Benefits Coordination & Recovery Center (BCRC) at 1-855-798-2627. TTY users should call 1-855-797-2627.

 

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Medigap Plans

How to Select a Medigap Plan

The graph below shows the various Medigap Plans and the various things they cover.

 

* Plan F also offers a high-deductible plan in some states. If you choose this option, this means you must pay for Medicare-covered costs (coinsurance, copayments, and deductibles) up to the deductible amount of $2,140 in 2014 before your policy pays anything.


** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission.

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Things to Remember When Comparing Plans

Always compare the same plans over various companies. For example compare the cost of "Plan A" from one company to "Plan A" from another.

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