Medical Insurance 101: A Brief 5 Step Introduction to Medigap

If you’re enrolled in Medicare, you’ll know it covers some healthcare charges. While this can be a great help, people who need tests, treatment or drugs must then find ways to pay the remaining costs.  Some do so out of pocket while others rely on separate insurance or supplemental insurance coverage. Understanding Medicare and finding the right supplemental plan can be difficult but that’s where agencies like Medigap come in.

Here are 5 things you should know about Medigap.

Medigap boosts your Medicare coverage

Medigap helps you to find private health insurance that covers copayments, coinsurance, and deductibles not covered by Original Medicare. As the name suggests, it fills in the gaps in federal/state-provided coverage and helps reduce out of pocket spending.

Medicap covers things Medicare won’t

There are some things that Medicare simply doesn’t cover at all. If you don’t have additional insurance, you will have to pull your pockets to pay. Medigap offers a Dental, Vision and Hearing plan which will cover most dental care, eye exams related to eyeglasses, dentures and hearing aids and exams.

Medigap can shield you from high bills

Medicare is quite helpful in meeting basic health care costs but it does not cover all of your medical expenses. It will pay for about 80 percent of approved expenses once you meet your Part B deductible. If your medical bills are particularly high, you may not be able to afford this 20 percent since it could run in the tens of thousands of dollars. A Medigap policy can help with this. 

You can choose from several insurance companies

There are ten standardized Medigap plans offered by more than 30 insurance companies including Blue Shield, Cigna, Mutual of Omaha and AARP. Some plans offer the same benefits but at different price points so you can shop around to find the one which best suits your needs. You can find more information here. 

All plans have the same doctors’ network and claims-paying process

Every plan and company under Medigap is able to access to the full Medicare network of doctors. That is because Medigap is a supplement to Medicare. If your doctor takes Medicare, they’ll take Medigap.

There is also an automated claims-processing system in place for every plan offered by every company. When your doctor files a claim, it goes to a third-party company which will know which plan and company you have.  They will file the claim with Medicare and the supplement insurer.

All you are required to do is show your Medicare ID and maybe your Medicare supplement ID, to your doctor. This applies regard of which company you do business with and which plan you have.

Choosing for the right Medigap plan depends on which plan best meets your needs at a price which you can afford. Since many companies offer the same benefits at different prices you may want to decide based on your familiarity with a brand, customer service, financial strengths or reviews from people you trust.

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