What Does Medigap Provide?
Medigap health insurance policies, available to any Medicare recipient, serve approximately the same functions as other secondary healthy care policies, such as those provided by businesses to retired employees. If you have already enrolled in Original Medicare, or are approaching the time you will enroll, and you do not have secondary coverage, take time now to learn all you can, not only about Medigap coverage but also about Medicare Parts A and B.
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Covering the Gaps
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Medigap policies provide additional health insurance to reduce your out-of-pocket cost for health care services. They do that by paying part of Medicare's co-insurance, co-payment and deductible charges for you. In addition, some Medigap policies cover the cost of activities not included in Original Medicare.
Medicare recipients purchase Medigap policies from private insurance companies. If you already have some form of supplemental coverage---Medicare Advantage Plans, Veterans Administration (VA) benefits, TRICARE or employer/union group coverage---you do not need a Medigap policy and, in fact, may not purchase one.
Medicare's educational materials provide an extensive listing of the gaps in Medicare Parts A and B. See the "References" section as well as the Centers for Medicare & Medicaid Services' publication, "Medicare & You 2009" for the complete list.
Medicare Defined Policies
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The U.S. Department of Health and Human Services requires that insurance companies who want to add Medigap policies to their portfolio, sell one or more of 12 "standardized" plans (A through L). As a result, the only difference between the policies offered by different insurance companies is their cost.
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Requirements
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If you want to purchase a Medigap policy, you first must be a Medicare Part A and Part B recipient. Your Medigap policy will be additive, meaning you will pay both your monthly Medicare premiums and the premium for the Medigap coverage.
Medigap coverage also is individual. Consequently, eligible individuals in your household must purchase their own Medigap policies.
Medigap Gaps
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Medigap policies do not include coverage for long-term nursing home care, vision, dental care, hearing aids, eyeglasses or private nursing care.
Your six-month Medigap open enrollment period begins on the first day of the month you celebrate your 65th birthday and enroll in Medicare Part B.
During "open enrollment," your insurance company must sell you any Medigap policy it offers without making you wait for your coverage to charge you higher premiums because of your health. Outside that open enrollment period, the insurance companies can, and probably would, do both.
Considerations
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You can purchase a Medigap policy from any insurance company licensed in your state. Once you have done so, the insurance company must renew your Medigap policy without regard to any health problems you may have developed.
Since there now is a separate Medicare Prescription Drug Plan, Medigap policies do not include prescription drug coverage.
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