In the United States, Medigap is also known as Medicare Supplemental Insurance. Unlike Medicare which is administered largely by the government, Medigap insurance programs including the benefits are contracted to private insurers. Recent statistics show about 20% of Medicare beneficiaries are also covered by Medigap.
Medicare typically covers enrollees who are 65 years old or over. Enrollees under 65 must either be covered because of a disability or other qualifying condition. Although they cannot simply buy Medigap some states have recently begun requiring some Medigap plans to be made available for this group of people.
There are three options for enrollees, Original Medicare, Medicare Advantage, and Original Medicare with Medigap Supplemental Insurance Plans. One glaring difference between Medigap and the Medicare Advantage plans is that Medigap does not make any decisions about what to cover, the federal government states what is covered within each Medigap Plan. Medigap features no networks of hospitals or doctors for the enrollee to select. It merely directs them to the specified share of their medical bills that Medicare doesn’t cover (for co-pays or deductibles for Medicare part A or Part B). To simplify the process, if an enrollee’s healthcare benefit was paid for by Medicare, but there is an outstanding bill, Medigap steps in to offset it.
With the exception of Wisconsin, Minnesota, and Massachusetts, Medigap is available in 10 distinct benefits packages. These vary according to how much of the healthcare expenses the enrollee is being covered for. Premiums are determined by the number of healthcare benefits covered or the amount of the bill to be covered.
The most popular Medigap plan is F which is not rated. When browsing Medigap plans, enrollees are sometimes taken aback by this, but the absence of a rating is simply because the benefits are the same regardless of which private insurer the enrollee purchases coverage from. It pays for everything that Medicare doesn’t. It even goes further and pays for the outstanding bill that is assessed by hospital systems and doctors who don’t accept payment-in-full by Medicare
Unlike the Medicare Advantage plans, the rules governing Medigap may vary from state to state. All the Federal government does is regulate the minimum consumer protection rules, but individual states are free to decide to modify or add any additional consumer protections.
After each hospital visit, the private insurance companies administering Medigap contact Medicare to compute the amount of the outstanding bill and automatically pay their share. No hospitals or networks are involved.
Learn more about Medigap plans and rates at http://emedigap-plans.com. Medigap Insurance brokers will help you compare Medigap Insurance rates and plans. To talk to an expert in Medigap coverage call toll free 888-452-7949!