Medigap Plan

As your parents begin to reach their senior age, you want to make sure they’re in good health, happiness and their needs attended to. According to the American Association of Retired Persons (AARP), around 30 million American households are providing care for an adult over age 50; a number that is expected to double over the next 25 years as life expectancies increase.

Out of the important things to educate yourself on is what kind of health plan your parents have. Different plans have different coverage. You’ll also want to see if they have coverage from their work. They may have a combination of benefits, so you’ll want to find out exactly what each form of coverage provides. Another factor to look into is if they have enough coverage. Review all aspects of their coverage, and see if it is enough for the care they require now and might require in the future.

What there is to Know About Medigap

You don’t have to be proficient in Medicare to know how to help your parents. But you do have to know that Medicare doesn’t cover everything, which is where Medigap, fills in the gaps, so to speak.

What is Medigap?

If you have the Original Medicare, you will probably supplement it with a Medigap plan. Medicare has four basic parts: A, B, C, and D. Parts A is for hospital care, B doctors, medical procedures, equipment, and D prescription drugs. Medicare Part C is administered by private insurance companies contracted with Medicare.

By the age of 65, your parents will have to pay inpatient and outpatient deductibles, as well as co-pay for things such as doctor visits. The most expensive thing to pay will be the co-insurance. Medicare part B pays 80% of your expenses, so the other 20% is on the patient for things like lab work, diagnostic imaging, medical supplies, and other things as chemo, radio or surgery. There’s no cap on that 20%, meaning a senior will pay it ongoing.

They can protect themselves against those expenses by paying for a Medigap plan (sometimes also called Medicare Supplement) which is a supplement health care insurance policy and fills in the gaps of Medicare’s coverage. 

How Medigap works

A medical provider bills Medicare for your health care. After that, Medicare processes your claim and pays; minus the deductibles and coinsurance that we talked about. Medicare will then send that remains part of your bill to your Medigap company. There are currently several plans and if you click here, you can compare different Medicare supplement plans. They’re sold by private insurance companies, not the government. However, the plans are strictly regulated by state insurance regulators.

Most people will have a choice of standardized plans, and each plan covers different sets of benefits. It’s important to understand that the Medigap will become your primary insurance coverage.

Advantages of Medigap

Choice of doctors and hospitals: This is by far the biggest advantage of choosing a Medicare supplement plan. You can see any doctor in the US who accepts Medicare. This is very practical for seniors who might do a lot of traveling within the USA. There are also plans that provide coverage outside of the USA. But keep in mind that you will not be reimbursed for services from providers who do not accept Medicare.

No paperwork: With some other types of plans, you need a referral to go to a specialist. This is a lengthy process and can take weeks. Whatever Medicare covers, Medigap also has to cover, and you basically call the shots of which medical doctor and medical facility you go to. You don’t need to have the referral paperwork done to go to a specialist.

Covers what Medicare doesn’t cover: Medigap covers Medicare parts A and B, which are the major foundations of Medicare. Around 60% of Americans are on Medigap, which shows that it’s a preferred method of seeking coverage for medical costs.

Supplement cost: Most costs are very affordable, some starting at $50 or less per month. Generally, you’ll get great coverage at around the $100 a month mark.

As parents age, it’s normal to know more about and get involved in what their health plan is. When you know your parents are being well-taken care of and are settled into a Medigap plan, this will put their and your mind at ease. It’s a decision that is crucial and you can help your parents make it. When aging parents feel secure about their medical future, it allows for more freedom to spend their golden years the way they want to.