Medigap is a private insurance plan that helps cover out-of-pocket costs for Medicare enrollees who have Original Medicare plans (Part A and Part B). Medigap can cover deductibles, coinsurance, and copays normally owed after Original Medicare has paid their part.
Medigap is an alternative to having one Medicare Advantage plan that offers Part A and Part B coverage rolled into one. It is simply a supplemental plan that fills in the gaps, leaving you with less out-of-pocket expense. You’ll pay your private Medigap provider a monthly premium to be covered, on top of your Part B premium. You can’t have both Medicare Advantage and a Medigap policy.
Benefits of a Medigap Plan
- If your health worsens, you don’t have to worry about losing your plan. You can always renew your Medigap plan as long as you’re up-to-date on your premium payments.
- Some plans cover you if you travel out of the country, which Original Medicare doesn’t do.
- Access to any provider, within the U.S., that accepts Medicare.
Drawbacks of a Medigap Plan
- Long-term care and private-duty nursing isn’t covered by Medigap.
- Other benefits not provided by Medigap are dental, vision, and hearing aid coverage.
Is Medigap ending in 2020?
Our government has changed some of the rules concerning Medigap recently. Their concern is that by covering the deductible for Part B, Medigap incentivizes going to the doctor often. By blocking Part B deductible coverage, everyone will have a small price to pay to see a doctor and will think twice about getting care.
If you have enrolled in Medicare prior to Jan 1, 2020, you can still get Medigap that covers your Part B deductible. If you were eligible, but didn’t enroll in Medicare before this date (because you were still working, for example), talk to an insurance agent to see if a Medigap plan is right for you and if you can still sign up.
Getting a Medigap Plan if You Enroll for the First Time After Jan 1, 2020
New Medicare enrollees after Jan 1, 2020 won’t be eligible for Medigap Plan C or Medigap Plan F, because they cover the Part B deductible. There are other Medigap plans, like Plan D and Plan G that will cover many other costs.
On these plans, you should know that the first time you receive care in a year, you’ll pay your Part B deductible, which is $198 in 2020. After you meet your deductible, your Medigap plan can then do its job paying for coinsurance and copays for your future services.
As we usually advise in our articles, it’s best to talk through your individual situation with us in person. We can let you know if Medigap will meet your needs, find you a Medigap plan, or recommend a Medicare Advantage plan that will fit your lifestyle better. We’re familiar with all kinds of different Medicare plans in Missouri and have been helping people choose the right plan for years. We’d love to help you become educated about your options.