Monday, February 14, 2011

What insurance can I buy to fill gaps in Original Medicare?

You may be able to buy a supplemental coverage policy that is designed to fill gaps in Original Medicare. Such a policy is called a “Medigap.” Medigaps can help cover Original Medicare deductibles, coinsurances and some additional benefits. If you do not have other supplemental coverage, such as a retiree plan, you might want to consider purchasing a Medigap policy.
There are different standardized Medigap plans, labeled by letters. Not all plans are available in all areas.  
The plans that were available before June 1, 2010, are labeled by letters A-L.
Starting June 1, 2010, there will be two new Medigap plans (M and N), and four plans (E, H, I and J) will no longer be sold.
  • If you bought a plan before June 1, 2010, you can usually keep it as long as you like. The benefits will not change. 
  • In general, if you are happy with your current plan, there is no reason to switch. If you decide to switch, you should get unbiased advice to make sure that the plan you pick fits your needs.
  • Remember that plans are not required to sell you a policy if you are not within a time that you have the right to purchase a Medigap.
Note: Massachusetts, Minnesota and Wisconsin have different standardized Medigap plans that you can buy.
Each Medigap plan pays for a particular set of benefits. Plan A offers the fewest benefits and is usually the least expensive. Plans that offer more benefits, like Plan F, are generally more expensive.
The most popular Medigap plans are C and F, because they cover major benefits and are less expensive than many other plans.

Prior to June 1, 2010 all Medigap plans were required to include the following basic benefits:

  • Hospital coinsurance coverage
  • 365 additional days of full hospital coverage
  • Full or partial coverage for the 20 percent coinsurance for doctor charges and other Part B services
  • Full or partial coverage for the first 3 pints of blood you need each year
All Medigap plans sold starting June 1, 2010 (including new plans M and N) must offer these basic benefits and also pay all or part of the hospice coinsurance for drugs and respite care.
Depending on which Medigap plan you choose, you can get coverage for additional expenses Medicare doesn't cover, including:
  • Hospital deductible
  • Skilled nursing facility coinsurance*
  • Part B deductible
  • Emergency care outside the U.S.
  • At-home recovery**
  • Preventive care that Medicare does not cover**
  • Excess doctor charges. “Excess charges” refer to the amount above the Medicare-approved amount “non-participating doctors” can charge

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