Medicare Supplement Insurance is more commonly known as Medigap because it was designed to fill in the gaps in coverage that exist in the use of Medicare Part A and Part B.
Medicare Gaps in Coverage
Medicare Part A
Medicare Part A covers hospital costs, inpatient skilled nursing, home health, and hospice care. While the plan covers the majority of the costs, there still exists certain cost you must pay out of your own pocket. This includes the following:
- A deductible per hospital visit
- Coinsurance payments
- Hospital services that last beyond 150 days per visit
- Co-insurance payments for skilled nursing care
- Certain home health care visits and services
Medicare Part B
Medicare Part B is optional coverage available for a premium that primarily covers outpatient care, such as:
- Medical equipment
- Laboratory fees
- Medical supplies
- Physical therapy
With Part B, you will be asked to pay coinsurance and deductibles as well. You may also encounter services that cost more than Medicare will pay. In these cases, you will be asked to pay the difference between the Medicare approved charge and the amount billed by the caregiver.
Where Medicare Supplement Insurance Comes In
Since the cost of deductibles, co-insurance, Part B insurance premiums, and services not covered by either Part A or B can still add up to a huge chunk of money in the event of serious illness, Medicare Supplement Insurance provides senior citizens with additional options.
Medicare Supplement Insurance policies are available in ten basic coverage packages, which are labeled policies A through L. Policy A contains only the core benefits. These same benefits are available in policies B through L, as well as one or more additional benefits per policy.
The core benefits pay for:
- Medicare Part A hospital co-insurance for days 61-90
- Medicare Part A lifetime reserve co-insurance for days 91-150
- An additional 365 days of hospital coverage beyond what is covered in Part A. This is a lifetime maximum, meaning it will max out after 365 days, whether you use the additional time in three years or ten.
- Part A and B three pint blood deductible
- Part B coinsurance
The types of additional coverage you will find in the remaining policies include:
- Part A and B deductible coverage
- Coverage of charges that exceed Medicare Part B maximum allowed amounts
- Foreign travel emergency care
- Part A skilled nursing facility coinsurance for days 21-100
- Certain home health aid services
- Certain prescription drug coverage
- Preventive care coverage
It is important for consumers to review all of the Medigap policies before deciding on the one that best meets their needs. It is also important to note that not all policies are available in every state. Each state decides which policies will be offered.
Where to Purchase Supplemental Insurance
Medicare Supplemental Insurance is available through number of private insurance companies.
Remember also that by law these insurance companies may not require anyone to prove insurability or to pass a physical exam prior to selling them a Medigap policy. If you qualify for Medicare, you automatically qualify for Medigap.
Medicare Supplemental Insurance is designed to fill in the gaps in Medicare Part A and Part B coverage. These gaps can be costly--more costly than paying the insurance premiums associated with the additional coverage. Take the time to look at your current medical and financial situation, then review all of your options before deciding how best to spend your health care dollars.