Medicare plans offer a lot of financial benefits to seniors. This kind of health insurance has their backs whenever they need basic medical care, as it covers two parts of this care: Hospital or inpatient care (Part A) and medical or outpatient care (Part B). As beneficial as it is, Medicare has some flaws. The insurance that provides it comes with a lot of co-payments, deductibles, and co-insurance that demand out-of-pocket payments. Medicare also provides duration-limited benefits; after you use up your Medicare-covered days, you handle all the costs on your own. This is where Medigap walks in to save the day.
How Medigap Works
Medigap plans were created to fill the gaps found in Original Medicare. It doesn’t offer any medical services; it only serves to cover the financial gap in the original plan. As the Medicare professionals at Medicare Wire explain at https://medicarewire.com/medigap/, Medigap plans are offered by private insurers to serve alongside your original Medicare plan, which is provided by the government. Medigap can only cover the cost of services provided in Original Medicare and nothing else, except for foreign travel costs which we’ll get to in a bit. In order to get Medigap benefits, you need to be enrolled in a Medicare plan first.
What Your Medigap Plan Covers
Original Medicare can become quite costly quickly due to many factors. For starters, you’ll have to have a certain amount of coinsurance and copayment in order to receive any medical services. You’ll also be responsible for paying deductibles; an amount you have to pay before your insurance kicks in and starts paying. So, even when Medicare provides coverage for Parts A and B of the plan, you’ll still have to pay in order to get these services.
In order to provide a solution, Medigap was introduced with 10 different plans lettered from A to N. All of these plans serve to provide partial or full coverage for the services not covered by Original Medicare. Depending on the plan you choose, you can get coverage in the following areas:
Medicare provides full coverage on Part A on the first 60 days of your hospital stay, after which the percentage of the coinsurance you pay gradually increases until you’re paying the full costs. All Medigap plans cover the coinsurance of Part A, with an additional 365 days paid for. As for the copayments and coinsurance paid for hospice care and Part A deductible, the plans can offer anywhere from 50% to 100% coverage. The only exception is Medigap Plan A, which doesn’t cover Part A deductible.
Medicare also requires payment of deductibles, coinsurance, copayments, and additional expenses after the covered period of service ends. Medigap plans can cover 505 to 100% of the copayments and coinsurance depending on the plan. Only Plans C and F pay for Part B deductibles, while Plans F and G are the only ones that pay for the additional charges.
Medigap plans all pay for the first 3 pints of blood, which is the amount you’ll have to pay for before receiving any Original Medicare benefits.
Most Medigap plans provide coinsurance coverage, ranging from 50% to 100%, on skilled nursing facilities for short or long-term care.
While this is not included in Original Medicare, some Medigap plans offer coverage on foreign travel expenses, each according to the limits of the plan. The plans that cover foreign travel are C, D, F, G, M, and N.
What Medigap Doesn’t Cover
On the other hand, Medigap don’t cover all the gaps present in Original Medicare. As mentioned previously, it only covers what’s already included in the original plan. Some of the medical and healthcare services that aren’t covered in either Medicare or Medigap are the following:
- Long-Term Care, where seniors receive care in nursing facilities for chronic diseases and illnesses.
- Personal Care, such as bathing and shopping, and housekeeping.
- Dental Care, as they don’t cover either of routine examinations or dental procedures.
- Hearing Aids, unless the doctor deems it medically necessary.
- Vision Care, such as eye examinations, glasses, or lenses.
- Any Medical Care Acquired Outside The U.S., unless you’re enrolled in a Medigap plan that covers foreign travel.
Medigap cover the gap found in costs accumulating in Original Medicare. Depending on the plan you enroll in, you’ll receive different amounts of coverage on the deductibles, copayments, coinsurance, and additional costs. Medigap only cover medical services included in Original Medicare. Except for foreign travel, it won’t cover any other medical services.