Six Important Factors to Keep in Mind While Choosing Medigap Plans

Medicare and Medigap plans can be quite comprehensive and complicated to understand. When you are new to Medicare, it is imperative to choose wisely and take up a policy that will cater to your needs by providing best coverage and value for money.

Understanding the difference between Medicare and Medigap is the first step. Medigap does not form part of your original Medicare insurance coverage and has to be purchased separately from a private insurance entity. Even the best Medigap plans do not cover long-term policies, vision care, private duty nursing, and sometimes prescription medication. A monthly premium is paid for Medigap along with your original insurance policy. Medigap is available to people who are already insured with Medicare Part A and Medicare Part B; the distinction is to pay for hospital services under Part A and cost for doctor services under Part B.

The best Medigap plans are labeled from A to N, which offer different levels of health coverage under the various labels. Open enrollment for best Medigap plans is in the first six months after the applicant turns 65 to be eligible for the various policies under A to N; however, this excludes Policies E, H, I, and J which are not available to new subscribers. Major factors that influence the best Medigap plans and supplement insurance include your age, the location where insurance is being availed, marital status, and most importantly, the healthcare costs that you have incurred or plan to incur.

Here are six things you should know to get the most out of the best Medigap plans:
Understanding types of plans

  • The major differentiating factor when it comes to Medicare and best Medigap plans is pricing policy.
  • It should also be noted that Medicare Advantage and Medicare supplement plans are completely different since Advantage plans will not be standardized and will vary in benefits offered by the various private companies.
  • Also, you are eligible to change Medicare Advantage plans only during the annual election period, unlike other Medicare and best Medigap plans.

Compare plans

  • Since the best Medigap plans have to be purchased separately from private companies, be sure to compare the pros and cons of taking up the policy against each of the top insurance companies.
  • The most popular Medigap supplement policies are Medigap plan F, Plan G, Plan N, and Plan F-HD.
  • Pricing options and allied benefits of Medigap supplement plans will differ accordingly which is why it is important to gather relevant information and statistics.

Insurance agents versus buying on your own

  • This is an ongoing debate since many people would prefer professional help when it comes to choosing the best Medigap plans and policies.
  • However, you have to keep in mind that insurance agents and brokers at the end of the day are working for the best interest of private insurance companies.
  • This means, their efforts are more inclined towards selling policies on behalf of the company, which is why finding the right representative to guide you through your application process is important.

State Medicare and Medigap laws

  • Laws and state regulations will differ accordingly, which is why these are two very important things to be kept in mind while choosing the best Medigap plans.
  • The laws will directly affect you policy premiums to be paid on the plan, due to a concept which is known as attained age pricing.
  • Attained age pricing states that the premium to be paid on the Medigap plan taken will increase as per your age after eligibility and can be in the range of 2% to 3% every year.
  • The alternative to this would be issue age policy which does not allow for the age-based premium inflation. However, issue age policy is only available in a handful of the fifty states in the country.

Changing plans

  • Everyone knows that plans and policies can be changed only during the annual election period, which starts in October continuing through December.
  • However, not many people know that this election period only pertains to Medicare Advantage plans and Part D subscription plans.
  • This means you can change and opt for better pricing on best Medigap plans and supplement policies any time of the year.
  • Since Medicare cost is a major influencing factor when it comes to choosing the best Medigap plans, they include:
    – Deductibles and co-pays for original Medicare policy
    – Policy costs that will be incurred for the current Medigap and supplement insurance options
    – Co-payment for prescriptions medications which are covered under your policy
    – Long-term insurance care
    – Other out of pocket expenses.

It is to be noted that very few Medigap plans offered by private entities cover these costs, which is why changing from your current plan to better pricing options must consider all these points.

Resources for Medicare and Medigap reference

  • Medicare and Medigap are two concepts, with a lot of information to comprehend
  • Medicare & you guide and The guide to choosing Medigap policy are two very useful publications one can refer to before opting for best Medigap plans.
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