Medicare Supplements Plans Fix the “Gap” in Medigap.
What Is The Gap In Coverage?
Medicare Part A- Inpatient Hospital Stay-
Days 1-60 $1632 Deductible
Days 61-90 $408 per Day
Days 91-150 $816 Per Day
Medicare Part B- Medical Coverage-
Annual Deductible- $240.00
20% Co-Insurance
Your Medicare Supplement(Medigap) Plan Will Cover Most or All Of Your “Gaps” In Coverage.
Medicare Supplements have been around since 1980. Since Original Medicare does not cover 100% of the Hospital (Part A) and Medical (Part B) costs, Medicare Supplement/Medigap plans were devised to help Medicare Beneficiaries cover their cost share or, “Gaps” in the Original Health Insurance coverage. Since Original Medicare is still the Primary Payer and the Medigap plan is Secondary there are no Doctor or Hospital networks. The only requirement is that the Doctor or Hospital accept Medicare making the plans portable and able to be used in any state. As if things weren’t confusing enough with A, B, C, and D Medicare, Medicare Supplement/Medigap Plans are also designated(Plans A-F).
Medicare Supplement/Medigap plans have “Standardized Coverage,” meaning the coverage between them is generally the same, with differences being the cost of the monthly premium and cost share associated with it. Some plans offer enhanced benefits such as 100 Days in a Skilled Nursing Facility instead of the standard Medicare 20 days. But, Original Medicare does not cover items like Dental, Vision, Hearing Aids, and Gym Memberships, which means your Medicare Supplement/Medigap doesn’t either.
Prescription Medications–
Original Medicare does not cover prescription medications so your Medicare Supplement/Medigap plan won’t either. A Part D Prescription Drug Plan must be added and is available from private insurance companies.
State Rules–
There are differences between states as when someone can enroll in a Medigap plan including Medical Questionnaires and pre existing conditions issues. Our discussion pertains to individuals residing in the State of New York where preexisting conditions are limited with no Medical Questionnaire used.
To better see plan differences I have included a plan chart for your convenience.
Medicare Supplement Plans FAQ
What Does The Term Medigap Mean?
Since Medicare does not pay 100% of Medical costs(Your cost Share with Part A Hospital is $1600+ and Part B Medical is 20%) your cost share is considered a “Gap” in coverage and “Medigap” plans are designed to cover you in the Gap.
Do Medicare Supplement Plans Cover Prescription Medications?
No, Medicare Supplements only help with Medicare Parts A and B cost sharing. A Part D Prescription Drug Plan must be added. Medicare does cover certain injectable medications administered in a hospital and/or facility, which would be covered under Medicare Part B.
Do Medicare Supplement Plans come with Dental and Vision Coverage?
No. Medicare Supplements only help pay your cost share for Medicare Parts A and B which do not cover Dental and Vision services.
Is A Medicare Supplement Plan Better than A Medicare Advantage Plan?
That all depends upon an individual’s needs. Care should be taken when choosing a plan and all options should be considered.
Mike Miligi- Owner- Michael M Insurance Services
For over 10 years, Mike has been assisting Seniors and other Medicare-eligible individuals in understanding the ins and outs of Medicare and Medicare Health Insurance options, including Medicare Advantage Plans(Part C), Medicare Supplement Plans(Medigap), Prescription Drug Plans(Part D), and Dental and Vision programs.
Mike is Licensed in seven States and Certified with 11 Insurance Carriers. He has helped thousands of individuals decide on the best course of action for their particular Health Insurance needs. Because Mike is an Independent Medicare Health Insurance Broker, he works for the client, not the Insurance Carriers, and is able to provide his clients with accurate and unbiased Health Insurance options.
