Understanding What Medigap Insurance Covers

By Larry Price


If you are reaching the age of retirement, it is a good idea to start looking in to how you apply for Medicare and gap policies. First, it is important to understand what gap plans do. These plans are in addition to your government coverage that is purchased from private companies. The Medigap insurance pays for costs that your Medicare does not such as deductibles, co pays, and care you received outside of the country.

It is important to note that gap plans do not pay for vision care, dental care, hearing aids, or eyeglasses. Also, there is no plan that covers private duty nursing or long term care. Part D is a separate plan people have to select to cover the cost for prescription medications. The gap premium is paid monthly to a private company that is separate from the Medicare B premium.

Only folks who are already covered by Medicare A and B are eligible for gap insurance. Part A covers hospital and part B pays for doctor costs. It is important to know that if you have an Advantage plan, the gap coverage is not available to you. It is also important to learn which plans are offered where you live. Information is available online or through the department of insurance for your state.

Standard gap plans are labeled A through N, and provide various coverage levels. Side by side comparisons of these plans is always a good idea. Comparison helps folks choose the coverage that will best meet their needs. Keep in mind that if you are a new subscriber, you can not get E, H, I, and J plans.

The monthly cost for the gap coverage varies across the companies that offer the plans. However, benefits of the standard plans are the same. For example, gap plan C offers the same group of benefits no matter which company offers it. There are some states that have different standard gap policies.

The time to buy gap policies is during the period of open enrollment. Enrollment time is 6 months before the first day of the month you turn sixty five. In order to qualify for gap coverage need to have Medicare part B or be within six months of the date of enrolled. People can buy coverage during this time for the same cost a person with no health issues.

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.

Premiums are dependent on the policy that you select, where you live, how old are you, and the insurance company you purchase from. Paying your premium on a standardized plan on time guarantees that you will be renewed. Even if you have a pre existing health problem, you will be guaranteed the policy will renew.




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