Insurance Basics: Everything You Need to Know

Understanding The Role Of Medigap Insurance In Supplementing Medicare Coverage

Original Medicare is an invaluable program that makes it easier for individuals to get essential medical care. However, it does not cover all healthcare expenses, which may leave individuals responsible for paying out-of-pocket costs. These expenses can become overwhelming for individuals with conditions needing regular treatment. Luckily, Medicare insurance providers can provide the supplemental coverage you need.

What Are The Limitations Of Original Medicare Coverage?

A major limitation of original Medicare is that beneficiaries are responsible for covering various out-of-pocket expenses. These include deductibles, copayments, and coinsurance. These expenses can add up quickly and become a financial burden for many individuals. In some cases, individuals may have to forego essential types of care due to the expenses involved.

Original Medicare also has limited prescription drug coverage. For example, your medications may only be covered if administered in a hospital or at your doctor's office. However, a comprehensive drug plan is not part of the original Medicare. This means beneficiaries must seek additional coverage through a standalone Part D plan or another option like a Medicare Advantage Plan.

What Is Medigap Insurance?

Medigap insurance is designed to help fill gaps in Medicare coverage by covering certain out-of-pocket costs. Private insurers sell these policies in compliance with federal regulations that standardize benefits across different plans. This can make it easier for individuals to compare policy offerings from various providers. While it will still require some research to find the right option, choosing a policy that works for your health needs and your budget will be worth the time. However, it is essential to note that most Medigap policies do not provide prescription drug coverage. Instead, beneficiaries must enroll in a separate Part D plan designed for this purpose.

Who Is Eligible For Medigap Insurance?

Once you reach the minimum age, you will be able to purchase a Medigap policy during the open enrollment period or the first few months following your birthday. During this time frame, insurers cannot charge you higher premiums based on your health status. Additionally, a yearly open enrollment period will serve as a chance for you to make any necessary changes to your coverage.

Individuals enrolled in Medicare are generally eligible to purchase a Medigap policy from a private insurer licensed within the state where their primary residence is located. If you move to a new state, you will need to buy a policy for the state where you are moving. Fortunately, you will not have to wait for open enrollment to resume this coverage.