Original Medicare Supplement Insurance: What to Know About Medigap Plans

While Medicare provides essential health insurance for Americans ages 65 and older, it doesn’t cover every medical expense, which is why you will need to add supplement insurance.

Medicare Overview

Medicare Parts A and B (together known as original Medicare) cover hospitals, doctors’ care and certain other expenses, but they have hefty deductible and coinsurance costs and neither covers prescription drugs.

Supplement Insurance

Original Medicare can be paired with Medigap supplement coverage. The alternative is a Medicare Advantage plan. For more information on this type of plan and to compare Medigap versus Medicare Advantage plans, visit the education center at medicareondemand.com.*

What Is Medigap?

Medigap plans are sold by private insurers. Those who choose this option keep original Medicare, add prescription drug coverage through Medicare Part D and then buy a supplement plan. The supplement plans help cover original Medicare gaps, such as deductibles, copayments and coinsurance. For example, original Medicare pays 80% of services covered under Part B; Medigap insurance usually covers the remaining 20%. Some plans may also provide coverage for services like emergency medical care during foreign travel.

One advantage of this approach is that original Medicare and Medigap can be used for every doctor and hospital throughout the United States that accepts Medicare. What’s more, prior authorizations and referral from primary care doctors aren’t necessary.

Navigating Medigap Plans

There are 10 federally approved Medigap plans, labeled A through N, each with different combinations of coverage levels and costs. The design allows beneficiaries to choose the combination that best fits their health care needs and budget. You’ll find that choosing a Medigap plan is an exercise in trade-offs.

The federal government mandates that each of these Medigap policies must provide the same basic benefits regardless of the issuing insurer or location.

The Bottom Line

Because Medicare decision-making is complex, consider starting your planning process well before eligibility, which begins three months before you turn 65. In addition, seek the advice of a Medicare specialist along with your wealth advisor to help decide which type of Medicare and supplement insurance coverage is right for you.

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