Filling the Medicare Gap

Medicare is a wonderful single-payer health insurance benefit for those over 65. But, Medicare does not pay for everything. There are services not covered and there are other out-of-pocket expenses. For these reasons, many with Medicare still buy a supplemental insurance plan.

People have three basics choices for supplemental plans.

1. Some employers offer supplemental plans at a group rate for their retirees.
2. The federal government also subsidizes the Medicare Advantage Plan, which is part of Medicare coverage. Medicare Advantage Plans offer extra benefits and lower co-payments than the Original Medicare Plan. However, you may have to see doctors that belong to the plan or go to certain hospitals to get services. To join a Medicare Advantage Plan, you must first have Medicare Part A and Part B. You will have to pay your monthly Medicare Part B premium to Medicare. In addition, you might have to pay a monthly premium to your Medicare Advantage Plan for the extra benefits that they offer.
3. However, if you can not take advantage of either of these, you are left with purchasing a Medigap plan from a private insurer.

If you are one who has to purchase a Medigap plan you are in luck. As of June 1, 2010, the federal government has made some requirements of private insurers providing this coverage. Here are the results.

• Four of the plans offered previously (plans E, H, I, and J) may no longer be sold by private insurers because some of the benefits in these plans are now covered by Medicare or the Part D prescription drug plan.
• Private insurers are now offering two new Medigap plans at lower premiums. The first new plan is Plan M. This plan is less expensive, but there are a few higher costs for some services and you are required to pay one half of the $1,100 deductible. Plan N is also less expensive but will require a $20 co-pay for a doctor’s visit and a $50 emergency room charge.
• Plans being sold after June 1 must now also offer some coverage of drug costs and at least some portion of hospice care.

As a reassurance, because new plans are offered and old plans are being discontinued, if you purchased a Medigap plan before June 1 and want to keep it, you may, even the discontinued plans, and there will be no loss of benefits. People are also not required to buy new plans if they have one, but they can choose to switch.

Some states require private insurers to offer Medigap plans. In other states people may be denied Medigap policies or be charged higher premiums because of existing health conditions or advancing age.

Always check for the Medigap policy that’s best for you. eHealthInsurance gives you a comparative analysis of plans AND FREE instant quotes—just select Medicare as your type of insurance, type in your zip code, and click Submit; or you can Click here to get a free health insurance quote.

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