What consumers can expect from Medigap coverage

Medigap InsuranceAccording to senior Medicare adviser from PlanPrescriber, Steve Zaleznick, consumers with original Medicare have been watching their insurance premiums steadily climb, and it is recommended that these individuals carefully consider their Medigap supplemental coverage in order to make sure that adequate protection under a less expensive plan.

According to the director of benefits access policy of the Washington D.C.-based nonprofit advocacy organization, National Council on Aging, Hilary Sohmer Dalin, Medigap plans are designed to function with the original Medicare plan, and “Medigap wraps itself around Medicare and covers some or all of the out-of-pocket cost-sharing.”

Any insurer that offers a Medigap policy is required to provide the same standardized package offerings. That said, the price from one insurer to the next can vary widely, so it is highly recommended that you shop around before purchasing a policy. It is important to note that while insurers are not permitted to deny Medigap coverage to a customer within the first six months of having turned 65 years of age, after that point – with only a small number exceptions – an individual’s health can be taken into consideration before choosing whether or not to sell that customer a policy.

In the case of Medicare Advantage coverage – another opportunity for filling the Medicare gap – insurers cannot deny coverage during an open enrollment period.

Medicare Advantage plans are provided by private insurers and will generally offer all of the benefits in a single place, such as prescription drug coverage, outpatient care, and hospital care. It also offers additional coverage that is not included in Medicare such as vision and dental benefits, as well as assistance in covering the cost of a gym membership.

It should be noted that Medicare Advantage plans are different from Medigap in that they are not standardized from one insurance company to another so they must be carefully reviewed to understand what they offer.

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