Supplement Insurance Medicare
Medigap (Medicare Supplement) refers to various private supplemental health insurance plans sold to Medicare beneficiaries in the United States that provide coverage for medical expenses not or only partially covered by Medicare. Medigap's name is derived from the notion that it exists to cover the difference or "gap" between the expenses reimbursed by Medicare and the total amount charged. As of 2006, 18% of Medicare beneficiaries were covered by a Medigap policy.
Eligibility
A person must be enrolled in part A and B of medicare before they can enroll in a Medigap plan. During the open enrollment period which begins within 6 months of turning 65 or enrolling in Medicare Part B at 65 or older, a person may obtain a Medigap plan on a guaranteed issue basis (i.e. no medical screening required). Outside of open enrollment, the issuing insurance company may require medical screening and may obtain an attending physician's statement if necessary. Medigap insurance is not compatible with other forms of private Medicare coverage, such as a Medicare Advantage plan.
Products available
Medigap, offerings have been standardized by the Centers for Medicare and Medicaid Services (CMS) into twelve different plans, labeled A through L, sold and administered by private companies. Each Medigap plan offers a different combination of benefits. The coverage provided is roughly proportional to the premium paid. However, many older Medigap plans offering minimal benefits will cost more than current plans offering full benefits. The reason behind this is that older plans have an older average age per person enrolled in the plan, causing more claims within the group and raising the premium for all members within the group. Since Medigap is private insurance and not government sponsored, the rules governing the sale and offerings of a Medigap insurance policy can vary from state to state. Some states such as Massachusetts, Minnesota, and Wisconsin require Medigap insurance to provide additional coverage than what is defined in the standardized Medigap plans.
Some employers may provide Medigap coverage as a benefit to their retirees. While Medigap offerings have been standardized since 1992, some seniors who had Medigap plans prior to 1992 are still on non-standard plans. Those plans are no longer eligible for new policies.
Drug coverage
Some Medigap policies sold before January 1, 2006 may include prescription drug coverage, but after that date no new Medigap policies could be sold with drug coverage. This time frame coincides with the introduction of the Medicare Part D benefit.
Medicare beneficiaries who enroll in a Standalone Part D plan may not retain the drug coverage portion of their Medigap policy. People with Medigap polices that include drug coverage who enrolled in Medicare Part D by May 15, 2006 had a guaranteed right to switch to another Medigap policy that has no prescription drug coverage. Beneficiaries choosing to retain a Medigap policy with drug coverage after that date have no such right; in that case the opportunity to switch to a Medigap policy without drug coverage is solely at the discretion of the private insurance company issuing the replacement policy, but the beneficiary may choose to remove drug coverage from their current Medigap policy and retain all other benefits.
The vast majority of Medicare beneficiaries who hold a Medigap policy with drug coverage and then enroll in a Part D Plan after May 15, 2006 will have to pay a late enrollment penalty. The only exception is for the few beneficiaries holding a Medigap policy with a drug benefit that is considered "creditable coverage" (i.e. that it meets four criteria defined by the Centers for Medicare and Medicaid Services); a Medigap policy with prescription drug coverage bought before mid-1992 may pay out as much as or more than a Medicare Part D plan. Medigap policies sold in Massachusetts, Minnesota, and Wisconsin with prescription coverage may also pay out as much as or more than Part D.
Enrollment patterns
In 2006, 18% of Medicare beneficiaries were covered by a Medigap policy. Almost a third of Medigap policyholders (31%) live in rural areas; in comparison, roughly a fourth of all Medicare beneficiaries live in rural areas. Two-thirds of rural Medigap policyholders (66%) report incomes below $30,000.
See also
- Health insurance in the United States
References
- ^ a b "Examining Sources of Coverage Among Medicare Beneficiaries: Supplemental Insurance, Medicare Advantage, and Prescription Drug Coverage," Kaiser Family Foundation, August 2008
- ^ http://www.healthharbor.com/MedicareMedigap.html
- ^ a b Christelle Chen, "LOW-INCOME & RURAL BENEFICIARIES WITH MEDIGAP COVERAGE, 2006," America’s Health Insurance Plans, September 2008
Medicare.gov - Medigap (Supplemental Insurance ...
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Medicare.com - Medicare Supplement Insurance Plans (Medigap)
Medicare supplement insurance plans is also known as Medigap. Find out why it can save you money, what it covers, how much it cost and where to buy a Medigap supplemental plan.
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Compare Medicare Supplement Insurance (Medigap) plans and rates. Medicare Supplements provide supplemental insurance to fill in the gaps left by Medicare Insurance.
Medicare Supplement Insurance - Compare Plans and Rates
Provides Medicare Supplement insurance quotes and comparisons from leading companies
Medicare Supplement Policy
Medicare Supplement policy, or "Med Supp", helps fill the gaps in Original Medicare Plan coverage. Get additional information regarding Medicare Supplement policies.
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MWG Insurance Mall specializes in Medicare supplement services and Medicare supplemental insurance. We offer our clients quotes on plans from top health insurance providers for ...
Medicare.gov - Medigap (Supplemental Insurance ...
A Medigap policy must be clearly identified on the cover as “Medicare Supplement Insurance.” Each plan, A through L, has a different set of basic and extra benefits.
Wisconsin health insurance, Medicare supplement, health ...
WPS offers affordable health insurance for individuals and families in Wisconsin, with plans starting as low as $50 per month.
Medicare Supplement Insurance Rates Online
See rates and plans for Medicare supplement insurance online now with no obligation using our free tool that makes it simple.
Medicare.com - Medicare Supplement Insurance Plans (Medigap)
Medicare supplement insurance plans is also known as Medigap. Find out why it can save you money, what it covers, how much it cost and where to buy a Medigap supplemental plan.
AICPA Insurance Programs - Medicare Supplement Product ...
AICPA-endorsed Medicare Supplement - Provides choice of 10 plans to fill Medicare gaps. The Plan provides members with rates that are not available to the general public and does ...
Compare Medicare Supplement Insurance Plans & Medigap ...
Compare Medicare Supplement Insurance (Medigap) plans and rates. Medicare Supplements provide supplemental insurance to fill in the gaps left by Medicare Insurance.
Medicare Supplement Insurance - Compare Plans and Rates
Provides Medicare Supplement insurance quotes and comparisons from leading companies
Medicare Supplement Policy
Medicare Supplement policy, or "Med Supp", helps fill the gaps in Original Medicare Plan coverage. Get additional information regarding Medicare Supplement policies.
Medicare Supplement Insurance Home
Learn how a Mutual of Omaha Medicare supplement plan can reduce your out-of-pocket health care costs.
Dental Insurance, Individual Vision Plan, Senior ...
MWG Insurance Mall specializes in Medicare supplement services and Medicare supplemental insurance. We offer our clients quotes on plans from top health insurance providers for ...