Medigap describes various individual health insurance policies sold commercially in the United States to supplement Medicare. Some Medigap policies pay after Medicare and some pay just before Medicare. The premiums of Medigap policies are tax-deductible in certain circumstances. These include income under $80,000 for married people, and people over age 65. Medicare Part A and B cover healthcare expenses for individuals above these qualifications.
There are three basic options in most Medigap policies. The original pays the entire cost of Medicare. The second option has the coverage amount spread over the full period of coverage. The third option is a more affordable plan that has partial benefits paid for by the third party. Medigap plans offer different pricing options to accommodate varying needs.
Some of the common types of medigap plans are described below. Preferred Provider Organization (PPO) Plans pay a set fee for all the services provided by the network. This is the most popular plan. It offers wide ranging benefits and competitive rates. The disadvantage of preferred provider organization plans is that they can be quite expensive.
There are also two other major categories of medigap plans. One category is hospital deductibles and the other category is prescription drug costs. If you are suffering from an illness or injury that affects your ability to function normally, you will need extensive coverage. In such cases, long-term care insurance may be more appropriate than medigap insurance. Long-term care insurance covers routine medical care as well as emergency or critical care services.
You must closely examine the different options available and choose one that fits your needs and budget. Some of the main considerations include premium, deductible, network, co-pay, age, if applicable, coinsurance, and whether you need emergency care. If you visit the doctor regularly, it may be better to go for a higher deductible. However, if you visit the doctor rarely, it is advisable to go for a lower deductible. The type of policy and the amount of coverage will depend on your age and personal health history. Your choice of medigap policy and deductibles will affect the outcome of the cost.
While you wait for the right policy and the right deductibles, you can consider enrolling in Medigap policies offered by some private medical insurers. Though the rates offered by private medigap insurers are not as low as the rates offered by the government, it is still possible to get great discounts. However, you have to bear in mind that some of these private plans have higher premiums, higher deductibles and restricted enrollment periods.
Most private employers offer long-term and short-term policies to their employees. An employee can choose an appropriate plan according to his needs. One of the advantages of a short-term policy is that it allows you to take advantage of the “postpone” benefit. If you visit the doctor within the open enrollment period, you can get coinsurance out-of-pocket expenses. This can help pay for the cost of the Medigap policy.
In some cases, you can get extra money back from the original pays that was paid when you purchased the private company’s plan. Some private companies also offer the opportunity to convert medigap policies into Medicare Advantage Plans. This means that the policy holder will have to pay a Medicare Part D deductible as well as a Medicare Part A deductible. However, the advantage of buying into the Medicare system is that it will cover all of the costs related to health care. So if you buy into one of these plans, make sure you have adequate coinsurance and access to Medicare.