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Providing Healthcare Solutions to Seniors

MediGap

What is MediGap?

Also, known as Medicare Supplement insurance.  These are policies sold by private insurance companies. Medicare Supplement policies cover health care costs not covered by Original Medicare (Part A & B); such as copayments, coinsurance and deductibles.  Some policies may include coverage for services that Original Medicare does not offer – like medical care when you travel outside the US or additional skilled Nursing facility coverage.

Medicare Supplement Insurance (MediGap) Plans

Benefits

A

B

C

D

F

G

K

L

M

N

Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used)

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

Medicare Part B coinsurance or copayment

100%

100%

100%

100%

100%

100%

50%

75%

100%

100%

Blood (first 3 pints)

100%

100%

100%

100%

100%

100%

50%

75%

100%

100%

Part A hospice care coinsurance or copayment

100%

100%

100%

100%

100%

100%

50%

75%

100%

100%

Skilled nursing facility care coinsurance

 

 

100%

100%

100%

100%

50%

75%

100%

100%

Part A deductible

 

100%

100%

100%

100%

100%

50%

75%

50%

100%

Part B Deductible

 

 

100%

 

100%

 

 

 

 

 

Part B Excess charges

 

 

 

 

100%

100%

 

 

 

 

Foreign travel emergency (up to plan limits)

 

 

80%

80%

80%

80%

 

 

80%

80%

Things to Consider:

  • There is a monthly premium for a Medicare Supplement policy – and you must have Part A and B to qualify. This premium is paid to the Insurance Carrier.
  • The standard benefits for Medicare Supplement plans are the same no matter which insurance company you buy your plan from.  This is important to note because premiums for each carrier can vary.  
  • With a Medicare Supplement policy – you are not subject to a plan network.  You can go to any doctors who accept Original Medicare assignment!
  • The main enrollment period for a Medicare Supplement policy is within 6 months from the first day of your 65th Birthday or within 6 months of signing up for Medicare Part B.  This enrollment period gives you guaranteed issue.
  • You are able to change your Medicare Supplement policy to another Medicare Supplement policy at any time – however you are potentially subject to underwriting…In California there is the “Birthday Month Rule” where you can change your Medicare Supplement policy during your Birthday month WITHOUT UNDERWRITING!
  • There are several Medicare Supplement plans (A/B/C/D/F/G/K/L/M/N) each of these plans covers more or less of the gaps not covered by Original Medicare.  See below for a chart of plan comparisons
  • You will need to buy a separate Medicare Part D Prescription drug policy 
  • Medicare Supplement plan F is our most popular plan – this covers:
    • 100% of your Part A coinsurance
    • 100% of your Part B coypayment
    • Blood – 3 pints
    • 100% Hospice care coinsurance/copayment
    • 100% Skilled Nursing facility Care
    • 100% Part A deductible
    • 100% Part B excess charges
    • 80% Foreign travel emergency (up to plan limits)

How can we help you?

We can help you by laying out all of your options in a simple and easy to follow format.  Choosing a Medicare Supplement plan in itself is an easy decision but weighing up your options between Medicare Advantage vs.  Medicare Supplement vs.  Original Medicare does tend to get confusing and overwhelming.  We are committed to taking the time to clarify and answer any questions you have.  Making the right Healthcare choice for YOU is our priority!