Medicare Supplement (MediGap) Insurance
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Medicare Supplement (MediGap) Insurance
What happens when you turn 65 years old?
When you turn 65, you become eligible for Medicare, the federal health insurance program for people aged 65 and older. The main parts of Medicare are:
- Part A (Hospital Insurance) - Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.
- Part B (Medical Insurance) - Covers doctor visits, outpatient care, preventive services, and some medical equipment.
- Part D (Prescription Drug Coverage) - Provides coverage for prescription medications.
You are automatically enrolled in Medicare Parts A and B when you turn 65. You can then choose to enroll in a separate Part D prescription drug plan.
Many people also choose to get a Medicare Supplement Insurance (Medigap) plan to cover costs NOT paid by Original Medicare, such as deductibles and copays. Alternatively, you can get your Medicare benefits through a private Medicare Advantage plan instead of Original Medicare.
The costs for Medicare coverage include monthly premiums, deductibles, and copays/coinsurance, which vary depending on the specific plan you select.
This page will explore Medicare Supplement Insurance, also known as MediGap Insurance.
Original Medicare consists of two parts:
Part A (Hospital Insurance):
- Covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
- Most people don't pay a monthly premium for Part A if they or their spouse paid Medicare taxes while working.
Part B (Medical Insurance):
- Covers doctor visits, outpatient care, medical supplies, and preventive services.
- Enrollees pay a monthly premium for Part B coverage, which is deducted from their Social Security check.
Key features of Original Medicare:
- Beneficiaries can see any doctor or provider that accepts Medicare.
- There are deductibles, copayments, and coinsurance for services.
- There is no annual limit on out-of-pocket costs.
- Prescription drug coverage is not included and must be obtained through a separate Medicare Part D plan.
Medicare Supplement's (MediGap) Role:
Because Original Medicare does not have an annual limit on out-of-pocket costs, and because it does include dental, vision, or Rx plans, Medicare Supplemental (MediGap) plans are then added to "supplement" Original Medicare. Usually there will be additional premiums for the additional coverage. Use the Quoter to obtain a Quote or contact us for personalized assistance.
Pros of Original Medicare:
- Nationwide coverage - you can use any doctor or hospital that accepts Medicare
- No referrals needed to see specialists
- Predictable out-of-pocket costs with deductibles and copays
- Covers hospital stays, doctor visits, and some preventive services
Cons of Original Medicare:
- Does not cover prescription drugs
- Requires you to pay deductibles and coinsurance
- No annual limit on out-of-pocket costs
- Does not cover services like dental, vision, or hearing aids
Here are the typical steps for an insurance agent to enroll a client in a Medicare supplement (Medigap) plan:
1. Gather information: The agent will collect details about the client, such as their name, date of birth, Medicare enrollment information, and current health status.
2. Explain Medigap options: The agent will review the different Medigap plan options available in the client's area and help them understand the coverage and costs of each plan.
3. Recommend a plan: Based on the client's needs and budget, the agent will recommend one or more Medigap plans that would be a good fit.
4. Complete the application: The agent will help the client fill out the Medigap plan application, ensuring all required information is provided.
5. Submit the application: The agent will submit the completed application to the insurance company on the client's behalf.
6. Provide guidance: The agent will explain the next steps in the enrollment process and be available to answer any questions the client may have.
7. Assist with enrollment: The agent will work with the client and the insurance company to complete the enrollment and ensure the Medigap coverage is in place.
8. Provide ongoing support: The agent will continue to be a resource for the client, helping them understand their Medigap plan and make any necessary changes in the future.