What exactly is a Medigap Plan and do you need one??? Call us at iHealthBrokers at 888-410-0344. Our services are 100% FREE!
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0:00 Intro
Original Medicare 1:48
Premiums 2:38
Deductibles 3:03
Coinsurance 3:45
OOP Max 4:34
Plans are Standardized 6:07
Network 6:44
Enrollment 6:56
In order to pick a Medicare Supplement Plan (Medigap Plan), you first need to know exactly what a Medicare Supplement Plan is.
Medicare Supplements fill in the financial gaps of Original Medicare. They do not offer different benefits. They restructure the costs and step in to potentially save you from larger medical bills.
Original Medicare ie Part A (your hospital insurance) and Part B (your outpatient insurance). Original Medicare is very comprehensive coverage, but there are a few associated costs you should be aware of:
Premiums
Deductibles
Coinsurance/Copays
Your premium is the amount you pay on a a monthly basis to keep your insurance active. There is usually no premium to Medicare part B. The premium for Medicare Part B is based on your income. It usually increases on a yearly basis.
The deductible is the amount that you have to pay out of pocket before your insurance begins sharing the cost. The deductible for Medicare Part A is applied per benefit period rather than annually. You'll usually have to meet this deductible every time you are admitted to the hospital.
Things are simpler with Medicare Part B. The deductible is a once annual deductible. Once you've met it, Medicare will contribute to the costs and you will be responsible for coinsurance.
Coinsurance for Medicare Part A depends upon your length of stay. There is actually no coinsurance for days 0-60. So, after you've met your deductible, there will be no charge. There is, however, daily coinsurance past 60 days. It's unlikely you'll be in a hospital this long, but should you need to recover in a skilled nursing facility, this coinsurance could come into play. At that point, things may become expensive.
Coinsurance for Medicare Part B is 20% of the cost of Medicare covered services. You'll only be responsible for 20% of the Medicare approved amount. You must use a doctor who accepts Medicare and most do.
The issue with Medicare is the lack of an out of pocket maximum. With most insurance plans, should you need major medical care, if you hit your out of pocket maximum, you insurance will take on the remainder of the costs. This is not the case with Medicare. There is nothing to protect you from major medical bills. Unfortunately, our health needs do tend to increase as we age, so this is something to take into consideration.
There are many Medicare Supplement Plans to choose from. They offer different levels of coverage at different price points but they all work in the same way. They will all step in to cover a portion of the entire of your deductibles and coinsurance as long as you pay the premium for the Medicare Supplement Plan. They will also impose an out of pocket maximum to save you from major medical bills.
Remember, that regardless of who your carrier is, if your doctor accepts Medicare, they will accept your supplement plan. Make sure to pick a carrier with a history of low, stable price increases.
Additionally, plans are standardized, so shop around!
Finally, remember you can enroll in a Medigap Plan year round, but it's in your best interest to do so during your IEP. Your IEP is the 6 months after you turn 65 AND enroll in Medicare. During this time you will not be subject to medical underwriting. After this time you could be denied or charge more based on your health.
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What is Medigap
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