A beginners guide to Medigap Supplemental Insurance!

Remember These Important Facts

It is very Important to know the ends and outs of Medicare and Medigap Insurance.

There are four parts of Medicare: Part A, Part B, Part C, and Part D.

- Part A provides inpatient/hospital coverage.

- Part B provides outpatient/medical coverage.

- Part C offers an alternate way to receive your Medicare benefits (see below for more information).

- Part D provides prescription drug coverage.

Original Medicare consists of two parts: Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). Medicare Part A covers Medicare inpatient care, including care received while in a hospital, a skilled nursing facility, and, in limited circumstances, at home.

In Original Medicare you go directly to the doctor or hospital when you need care. You do not need to get prior permission/authorization from Medicare or your primary care doctor.

You are responsible for a monthly premium for Part B. Some also pay a premium for Part A.

You typically pay a coinsurance for each service you receive. There are limits on the amounts that doctors and hospitals can charge for your care.

If you want prescription drug coverage with Original Medicare, in most cases you will need to actively choose and join a stand-alone Medicare private drug plan (PDP).

Unless you choose otherwise, you will have Original Medicare. Instead of Original Medicare, you can decide to get your Medicare benefits from a Medicare Advantage Plan, also called Part C or Medicare private health plan. Remember, you still have Medicare if you enroll in a Medicare Advantage Plan. This means that you must still pay your monthly Part B premium (and your Part A premium, if you have one). Each Medicare Advantage Plan must provide all Part A and Part B services covered by Original Medicare, but they can do so with different rules, costs, and restrictions that can affect how and when you receive care.

Parts C and D are available through private health plans.

Why do I need a Medicare Supplement (Medigap)?

KEY TAKEAWAYS

• Medigap pays some or all of the costs Medicare doesn’t cover, depending on the level of coverage you choose.

• The costs of what Medicare doesn’t cover can be substantial, especially if you need extensive treatment or long-term hospitalization.

• Private insurance companies offer Medigap policies, so be sure to shop around.

What Is Medigap?

Medigap is a supplement to Medicare coverage. Depending on the type of coverage, Medigap policies are designed to cover all or part of the expenses Medicare doesn't cover—expenses such as long-term care, vision, or dental coverage. The purpose of a Medigap plan is to get reimbursed for the costs you pay for directly out of your own pocket. As is the case with any health insurance plan, you will pay a higher price for higher coverage. And a less expensive plan will have a higher deductible.

About 81% of current Medicare recipients have some sort of additional coverage through an employer or the government if not through a Medigap plan, according to the most recent data available from the Kaiser Family Foundation. These plans are offered by private insurance companies, so you'll have to do some comparison shopping to get the one that fits your needs and financial situation. Keep in mind that lettered plans from each company have the same benefits.

Why Buy More Insurance?

As noted above, Medicare isn't a blanket insurance policy. This means it does have holes in it. Original Medicare, as the government calls what we now know as parts A, B, and D, pays most of your expenses. But it's far from all of the costs you may face if you become seriously ill or get injured. Even routine services come with co-payments and deductibles. This is where Medigap insurance kicks in.