Medigap policies are controlled by private insurance companies which helps you cover some extra medical costs which an Original Medicare policy would not cover like co-payments, coinsurances and other deductibles. But you need to a part of Original Medicare Part A and Part B in order to avail the services of Medigap plans.
Some major constraints of being a part of Medigap policy
There are of course many constraints in order to enrol you in Medigap policies. The first rule is that you need to be at your retirement stage. That is, you are eligible to enrol only if you are above 65 years old. If you are younger than 65 years old, even having a serious health problem won’t help you get a Medigap policy. But then, there are some exceptions as well, in case of any fatal diseases. Again, if you are enrolled in Medicare Advantage health plan, i.e. Part C, then you are not eligible to enrol for Medicare supplement plans.
There are various plans and schemes of Medigap policies, but insurance companies can sell you only one scheme of the plan as per the legal rule. One person cannot be a part of two different schemes of the same Medigap policy.
Factors upon which your expenses for Medigap policy will depend:
- Which scheme and options of the Medigap plan do you choose?
- What is the frequency of your visit to the doctor or to the nursing home?
- Whether you are enrolled in some other health insurance plans that cover some of your medical expenses?
- Whether you are eligible for help with Medigap policies?
- Your income.
What is Medicare supplement plans Part A and Part B?
The various schemes of these plans are introduced by the government. If you have enrolled yourself in these two schemes, i.e. Part A and Part B, then only you are eligible for enrolment to Medigap policies.
- Part A: Majority do not pay the premium for Part A for nursing facilities, hospitals and home health care. After two months, you will receive coinsurance, and the deductible amount is $1316.
- Part B: This medical insurance covers the costs for home health care, physician visits, outpatient care, and preventive services. The deductible amount is $183, and $134 is the premium amount. If you are enrolled for Part B, then 80% of your medical expenses will be paid by the government.