You’re eligible for a Medigap policy, also called Medicare supplement insurance, if you’ve taken Original Medicare and opted for an Advantage Plan or other insurance plan that offers Medicare benefits. There are currently 10 different Medigap policies, all administered by the federal government. They cover different aspects of Medicare. Some Medigap policies offer only prescription drug coverage. Others provide a complete range of Medicare benefits and help individuals and families afford the high cost of Medicare.
Each Medicare supplement plans 2022 has different prices and premiums, based on a variety of factors such as age, sex, health, pre-existing conditions, country of residence, and whether you’re a Medicare recipient or an insured person. All medical plans are standardized in one or two ways. The basic benefits covered under each plan include: vision care and office visits; hospital stays; durable medical equipment coverage and preventive care; emergency care; prescriptions; pharmacy discounts; travel insurance and life insurance. Most plans offer at least some of these basic services, in order to make them more accessible. But there are other benefits that you may qualify for, depending on your specific circumstances.
The most common type of individual Medicare benefits available to seniors is the Part A premium. (The word “part” has a different meaning for seniors than it does for younger people.) This premium is standardized by the Internal Revenue Service and is based on a set percentage of income, with adjustments for different ages and health status. So, if you’re turning 65 in the next few months, you’ll be paying on a higher medigap plan than someone who is in his twenties.
On the other hand, there are several other advantages to medigap plans. If you travel outside of your home state, you won’t have to worry about out-of-pocket expenses for medical care. Even if you do travel outside of your home state, you may qualify for extra Medicaid coverage, which could save you hundreds of dollars per month. The bottom line is, having affordable coverage can save you a significant amount of money, especially if you travel out of state on a regular basis.
Medigap policies also typically cover out-of-pocket costs incurred from emergencies, hospital stays, emergency transportation, and prescription drugs. Any prescription drugs that the enrollee is taking, at any time, are usually covered under a Medigap policy. Certain medications that are only prescribed on an occasional basis, such as cold remedies, are not covered, even if they are medically necessary. And, if the enrollee is enrolled in Medicare Advantage Plans, out-of-pocket expenses for dental care, vision care, and emergency care may be limited if they are also Medicare Part A or B. If so, the provider must provide the coverage within the Medigap policy.
In order to be eligible for coverage through Medigap plans in any Medicare program, it is essential that the enrollees meet specific health insurance eligibility requirements. Each year, Medicare guidelines are updated to help enrollees keep abreast of changes to their circumstances. Some of the newest changes to the rules include a simplified procedure that lets enrollees switch from one Medicare Parts A and B to one Medicare Part C at any time. To find out if a particular Medigap policy would be right for you, simply call one of the Medicare representatives who handle Medigap policies and ask about their options.