Current or soon to be Medicare beneficiaries enjoy health coverage as a benefit from the program of the federal government. If you are new to it, you will know that Original Medicare comes in different parts – Part A and Part B. Medicare Part A is responsible for inpatient or hospital coverage like hospital services, limited skilled nursing facility care, hospice care, home health service (limited) and inpatient mental health services. Medicare Part b, on the other hand, is for outpatient or medical coverage. It covers preventive services, screenings, doctor visits, lab test, X-rays and more.
Despite the benefits that Original Medicare provides, it might not be enough. You have to deal with deductibles, copayments, and coinsurance and pay it out-of-pocket. Those were sometimes coined as “Medicare gaps”.Those out-of-pocket expenses may seem harmless at first, but as you take a closer look it isn’t. Deductibles, copay, and coinsurance can add up and eventually become heavy to handle. Especially if you get seriously ill, those expenses can add to your stress.
So what can you do to cover the Medicare gaps? Consider getting a Medicare Supplement plan.
To answer that, you must know what is Medicare supplement plan first. Medicare supplement plan is also called a Medigap plan. It can help you by paying the remaining Medicare-approved healthcare costs not paid by the Original Medicare. It includes but is not limited to deductibles, copayments, and coinsurance.
Medigap is sold by private insurance companies hence you will have to pay an additional premium (aside from Medicare part B premium). Depending on the type of Medigap, it will all or part of the expenses left by Original Medicare. It has about ten different types, with varying levels of coverage. Compare the different Medicare supplement plans to find which will best fit your needs.
You will be eligible to enroll in a Medigap plan soon as you become 65 (or older) and has Medicare Part B. Soon as the two are being completed, your Medigap open enrollment period will start. That period will only last for 6 months and comes only once in your lifetime. During this period, you will have guaranteed issue rights benefits that will allow you to enroll in Medigap policy without being rejected. That is despite any pre-existing conditions that you may have at the time of your enrollment.
The cost of a Medicare supplement plan may vary from person to person, and from an insurance company to another. There are different factors that affect how much you will pay for a Medigap premium. One of them is the rating system that the insurance company uses to determine your premium.
Also, know that Medigap plans are standardized. Meaning, the benefits that a certain type of plan provides is the same no matter which insurance company sells it. Therefore, a more expensive of a certain kind of Medigap plan does not mean it will offer more benefits than the cheaper ones from other companies.
It can be hard to determine how much it will cost you if you don’t have a Medigap policy. Depending on how much medical attention you will need will reflect the amount of out-pocket costs that you will. But, here’s a summary of Medicare out-of-pocket expenses that you will possibly shoulder if you go on without Medigap. The data below shows the deductibles, copay and coinsurance costs for the year 2019.
Let’s say that you decided to ensure yourself with a Medicare supplement plan G. I chose that type of plan as an example because the most popular one, the Medigap Plan F, is going away on 2020. Medigap plan G is the next type of plan that offers the most comprehensive coverage next to Plan F. The only difference between the two is that Plan G does not cover the Part B deductible.
Going into Medicare isn’t an enroll and forget kind of task. It involves a major decision that you should take seriously because it will have a big impact on your future health coverage. If you are unsure of your decision, feel free to seek the help of an expert or to the insurance department in your state.