Medigap is a supplemental health insurance policy that helps to plug a hole in the compensation that you can receive from Medicare, the government program that assists that elderly with their medical expenses.
Medicare is divided into two parts.
Part A pays a percentage of the costs that patients incur from staying in a hospital. In addition, it covers some of the expenses that come from receiving treatment in facilities where skilled nurses provide essential medical procedures. Dialysis is a good example of this kind of treatment.
In addition, it pays for hospice care, and some health needs when the patient is at home.
Part B covers the expenses associated with the use of medical equipment that will last a long time, outpatient care not covered by Part A, and some services that are available to prevent diseases from occurring or getting worse.
Both parts of Medicare are available only to those who have joined those plans, but they don’t automatically come into effect simply because someone reaches a particular age.
In order to enroll in Part C, you must have joined Parts A and B first.
Part C allows you to choose the health care organization that you want to use. In so doing, you may be able to reduce the costs of the medical care that you need. Other benefits may also be available to you if you pay extra each month.
Part D is entirely voluntary. You don’t have to join it if you don’t want to. This part helps to pay for your prescriptions. Each of the medications it covers is assigned to one of four tiers, according to the cost of the drugs.
Generic medications and low cost drugs are on Tier 1, while brand-name and other expensive pharmaceuticals are classed as Tier 4.
However, these parts collectively don’t pay for everything.
For example, long term care is excluded. So are annual dental and eye exams which can become particularly important as we get older.
Dentures and hearing aids are also omitted from Medicare, as well as other procedures.
Medigap is the term applied to the coverage that some private companies provide to bridge the some of the differences between the provisions made by Medicare and the care that many patients actually need. In order to qualify, you have to be enrolled in both Part A and Part B of Medicare.
There are several types of Medigap plans available. Each depends of the benefits that are required. Although the prices that insurance carriers offer may vary widely in different areas, the coverage provided by each plan is the same. In other words, if you buy Medicare supplemental insurance in Florida, you would be afforded the same coverage as someone who bought the same plan in Ohio.
Part A, for example pays all of the expenses of coinsurance and hospital stays that exceed one year.
Part B pays for all costs due to coinsurance and copayments for some plans, but only 50 or 75% in others.
However, since 2006, Medigap policies have been prevented from including prescriptions.
Although Medigap insurance is neither designed nor permitted to pay all medical costs that are omitted by Medicare, it can make medical care more affordable to those who have reached retirement age.