In instances when Medicare may not cover all of your health needs, a Medigap plan may be of interest to you to make up for the extra costs that can accumulate. Medigap is a private health insurance plan that is sold to Medicare beneficiaries to supplement their health care coverage.
Every Medigap policy issued is required to meet federal and state laws in order to protect beneficiaries. These plans must also be identified as “Medicare Supplement Insurance” and can only be sold to you by a “standardized” policy by a letter in the mail.
Regardless of previous and current health conditions, Medigap policies must offer the same basic benefits. There are some that provide additional benefits in order for beneficiaries to choose one that meets their needs. Those who live in Massachusetts, Minnesota and Wisconsin should be aware that Medigap policies are standardized in a different way.
Companies who choose to offer Medigap plans must offer plans A, C and F. A Medigap policy will cover coinsurance after an individual has paid their yearly deducible unless he or she has a plan that also pays for this.
What does Medigap cover?
The Medigap plans available for purchase include A, B, C, D, E, F, G, K, L, M and N. Medigap coverage will cover 100 percent of Medicare Part A coinsurance and hospital costs. It also covers 100 percent of those same costs in Part B for plans A, B, C, D, F, G, M and N. It only covers 50 percent of benefits with Plan K and 75 percent with Plan L.
There are some benefits that Medigap does not cover including skilled nursing facility care coinsurance for plans A and B, Medicare Part A deductible for Medigap Plan A, Part B deductible for plans A, B, D, G, K, L, M and N.
Medigap Plans K and L cover 50 and 75 percent of benefits for blood tests and Part A hospice care coinsurance, respectively.
A Medigap policy will not cover the costs of long-term care, vision or dental care, hearing aids, eyeglasses or private-duty nursing.
Beneficiaries should also remember that a Medigap policy is not the same as other Medicare coverage. Veterans’ benefits, long-term care insurance policies, employer or union plans, TRICARE, Medicaid, Medicare Part D and Medicare Advantage Plans are not Medigap.