What Is Medigap?

The older we get, the more we come to depend on our healthcare coverage to protect us from the financial burden that unexpected medical expenses can bring. Medicare health insurance carries some of the cost; even so, it only takes one serious health problem to quickly drain needed financial reserves. Read on for more information on what Medigap health coverage and how it fits within your health insurance plan.

Identification

• The Medicare system is a federally funded health insurance program designed primarily for senior citizens, or those 65 years and older. This system is made up of two parts: Part "A" and Part "B." Combined, both parts cover a portion of your inpatient and outpatient healthcare costs; however, the remaining deductible requirements and copay costs are many. This is where Medigap comes in. As long as you're covered by Medicare Parts A and B, you qualify for the additional coverage that Medigap plans can provide.

Features

• Unlike the federally sponsored Medicare plans, Medigap coverage is purchased through individual insurance companies, all of which determine their own price rates. There are a total of 10 plan options to choose from--"A" through "J." Each plan has different coverages and costs. As with other types of insurance, the more coverage a plan provides, the more it costs. Since Medigap is offered by private insurance companies, plan coverages and pricing varies from state to state.

Function

• Medigap coverage is designed to coordinate with Medicare insurance so you end up paying as little as possible for healthcare costs. Individual circumstances will determine which Medigap plan will best coordinate with your current coverage. Some plans will provide more coverage for specific services than others, so if you anticipate needing hospice care or skilled home care, pick a plan that can best covers these specific services. Deductibles and co-pays vary from plan to plan, so evaluate the benefits within each one carefully. There are online sites that can help you determine which plan will save you the most money (see Resources below).

Types

• Medigap plan coverages are as follows"
  Plans "A"
  -coinsurance costs for hospitalizations covered by Medicare
  -coinsurance costs for Medicare covered doctors' bills
  -full coverage on 365 additional hospital days after Medicare covers the first 60 days
  -first 3 pints of blood
  Plans "B" through "J"
  -all the benefits from Plan "A"
  -hospital deductibles for Medicare covered visits
  -daily coinsurance costs for skilled nursing facility care
  -deductible costs for Medicare covered doctors' services
  -any difference in cost between a doctor's fee and Medicare's covered amount
  -custodial care
  -varied prescription drug benefits
  -preventative care
  -emergency oversees medical treatment
  As Medigap will only pick up where Medicare leaves off, any services, equipment or costs not covered by Medicare will not be covered by Medigap.

Time Frame

• The open enrollment period for Medigap is a 6-month window that begins the month after your sixty-fifth birthday. This is the best time to enroll simply because insurance companies cannot refuse to sell you a policy due to a previous health problem, or pre-existing condition. Also, premium rates remain the same across the board regardless of your health condition. Waiting periods for pre-existing conditions are shortened during this time, provided you were covered by some other form of insurance for at least 6 months before applying for Medigap.