Saturday, October 15, 2016

Understanding What Medigap Insurance Covers

By Larry Price


Folks who are approaching retirement age may want to begin applying for Medicare and checking out gap coverage. It is a good idea to learn what a gap plan offers. The gap plans are purchased from a private company and is in addition to Medicare. These Medigap insurance plans pay for those costs that Medicare does not. These costs include medical care received outside the US, co pays, and deductibles.

What the gap coverage will not pay for is dental and vision care or eyeglasses and hearing aids. In addition, there is no coverage for long term care or private duty nurses. Also, for prescription drug coverage folks will have to acquire a separate policy under Part D to cover their medications. Individuals will pay a premium each month for gap coverage that is separate from the Medicare B coverage.

If you already have Medicare A and B, you will be eligible to apply for a gap policy. Hospital costs are covered by Medicare part A while part B covers doctor costs. If you have an Advantage plan you are not eligible to purchase a gap plan. You will also need to find out which of the gap plans are offered in the area where you reside. This information can be found online on the State Department of Insurance website.

Gap plans A through N are the standard plans offering a variety of coverage levels. Do a side by side comparison of the plans that are available. This is the best way to see which plan has the coverage you will need. Keep in mind that if you are a new subscriber you can not get plan E, H, I, and J.

Each company charges different premium amounts for their coverage. It is important to note that all standard plans offer the same benefits. For instance, plan C has the same benefits regardless of the company that is offering it. Not all the states require the same standards for gap coverage plans.

The time to purchase a gap plan is during open enrollment. This is the period of time that is six months prior to the first day of your sixty fifth birthday month. However, you must be signed up for Part B of Medicare or within 6 month of when you signed up. You will be able to purchase the gap coverage for the premium a healthy person pays.

Attempting to purchase a gap policy after this window of opportunity has closed, does not guarantee you will be able to get the coverage. In the event that you do obtain coverage, you run the risk that your premiums will be higher. It is important to know that in addition to the premium you pay for Medicare B, you will be paying a premium to an insurance company for the gap plan.

The amount of the premium will be determined by your age, where you live, the company you purchase from, and the plan that you select. Once you have purchased your standardized plan, it is guaranteed renewable provided you pay your premiums on time. This guarantee extends even to those with pre existing health conditions.




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