What is Medigap and Do I Need it? | HealthTN.com

What is Medigap and Do I Need it?

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If you’re looking for an example of a large government program that’s difficult to understand, look no further than Medicare. Medicare.gov contains hundreds of pages of information – few of which are easy reading. At HealthTN.com, we encourage you to learn all you can, but ultimately, it is fare safer to get help from a pro.

But one of the most confusing aspects is why, given all of Medicare’s parts and pieces, Americans on Medicare are encouraged to buy even more health insurance: a Medicare Supplementary Medical Insurance policy, also know as Medigap. As experts in the field of helping Tennesseans understand all their options, here are some of the top questions and answers that may help –

  1. What is Medigap Insurance?
    Medigap is additional insurance for Medicare recipients. Insurance for your insurance, basically.
  2. Why do I need more health insurance?
    Because Medicare has hole (or gaps – get it?). “Original Medicare,” as the government calls it, defined as parts A, B, and D, doesn’t do a very good job of really covering you if you were to get seriously ill or injured. It pays some of your expenses, but far from all.That’s were Medigap insurance kicks in. Depending on the plan you get, Medigap will pay all or a portion of the costs Medicare doesn’t cover.
  3. Those “extra” charges can’t be that substantial, can they?
    Oh, yes they can. Here are a few examples. If you are admitted to the hospital and only have Original Medicare, you have to pay the first $1,216 of expenses. If you stay more than 60 days, you have to pay a portion of each day’s cost after that period. The size of your daily payment depends on how long you have been in the hospital and goes up the longer you stay.

    Doctor visits and medical procedures are going to cost you too. Your deductible is $147 but, after that, you have to pay 20% of “the Medicare-approved amount” for most doctor services. What if you have a $250,000 bill? Look for a $50,000 bill in your mailbox – even more if the Medicare-approved fee is lower than $250,000. There’s no limit on how high it goes.

  4. How do Medigap insurance policies work?
    Glad you asked! You know all those “parts” of Medicare? Parts A, B, and D? Medigap policies have parts of their own. They’re labeled with the letters, A-N (though E, H, I, and J are no longer offered. The last thing you need with Medicare is more letters, but these letters make the options consistent across every provider.

    Because private insurance companies offer these policies, you have to do some comparison shopping. Your shopping is made easier because and “F” plan, for example, is the same no matter which insurance company offers it. You don’t have to worry about one insurance company offering something different in the “F” plan than another does.

  5. Which Medigap insurance plan is right for me?
    You know what we’re going to say, right? “Talk with us – HealthTN.com or give us a call to get the English version – (615) 541-4257.” Here’s some other advice – First, read the Medicare publication, “Choosing a Medigap Policy.” In there, you’ll find a chart of each policy type and what it covers.
  6. Does a Medigap policy cover both my spouse and me?
    Unfortunately, it doesn’t. A Medigap policy covers only one person.
  7. Can the insurer cancel my Medigap insurance if I get sick?
    No…that’s illegal. As long as you pay your premiums, your policy is renewable for the rest of your life.

The Bottom Line

Original Medicare has coverage gaps. Without some type of supplemental insurance, you could end up paying a lot of money out of pocket. Medigap insurance closes those gaps. If you want help searching for a policy that is right for you, click here. Simply put, this stuff is hard. We help you to make it easy. That’s why we’re here – to help you!

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