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Medigap Plans aka Medicare Supplement

April 9, 2010

 

Let me start off by clarifying for everyone that Medigap plans and a Medicare supplement are the same type of insurance product.  These words are often confused and believed to be different things however they are the same product.  Medigap Plans (aka Medicare Supplement) are private health insurance policies that are built to supplement Original Medicare.  In general these plans help provide coverage in the gaps of Medicare – hints this is how the policies got their name.

 

A Medigap policy is required to follow different Federal and State laws which were setup to protect Medicare eligible individuals.  When a Medigap policy is sold it must be labeled in these specific words  “Medicare Supplement Insurance”. Insurance companies that sell these insurance plans are only allowed to sell “standardized” Medicare Supplements which are identified by different letters (A- J until June 1st 2010).  Each carrier (insurance company) offers the same basic benefits in their plan.  Since the Medigap plans are required by law to offer the same benefits, this means that the only difference between Medigap plans comes down to the price and the financial stability of the insurance company.

 

Is there anything a Medicare supplement does not cover?

YES.  Please know that Medicare supplements do not cover custodial care, which is commonly referred to as Long-Term care.  It also does not cover dental or vision services, hearing aids, eyeglasses, or private duty nursing care.  However, in certain situations lenses and frames can be covered after cataract surgery.

 

Types of insurance or coverage that are NOT Medigap plans?

1.       Medicare Advantage Plans – also referred to as MA or MAPD plans

2.       Medicare Prescription Drug Plans

3.       Major Medical policies, cancer policies, hospital indemnity policies

4.       Long-Term Care Insurance also known as LTC

5.       Medicaid, TRICARE, VA benefits



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