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5 Things You Should Know About Medigap

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Most workers in the United States below 65 years are covered by their employers’ insurance. However, after turning 65, you have several other coverages that you can consider to include your health. Mostly, you will be required to choose between joining a Medicare Advantage plan and joining a Medicare with a Medicare supplement plan commonly known as Medigap. 

Yes, it is known as Medigap because it fills in the gaps that are associated with Medicare. Before joining a Medigap plan, you may want to know some of the features of this health coverage. Here, we discuss seven important facts that you need to know about the 2020 Medigap health coverage plan. 

Medigap Covers Pre-existing Conditions 

What is a pre-existing condition? In health insurance (as in life insurance), pre-existing conditions are defined as the health problems you had before joining health insurance. Almost all health insurance does not cover a pre-existing condition. They include only the health problem that you contract after joining the insurance. Medigap insurance companies do cover pre-existing conditions.

However, they may refuse to cover it during the first six months after joining. After the lapse of six months, the Medigap insurance company covers your treatment costs.

Eligibility Requirements 

Is everyone eligible to buy Medigap insurance? While most people are qualified, there are eligibility criteria that you must meet. For you to be eligible, you must have Part A or Part B Medicare. Everyone under Medigap protection or in the Medigap open enrolment period has a right to buy a Medigap policy.

However, those who are in a Medicare Advantage plan or have Medicaid might not be able. Also, it is not available to people under 65 who have a terminal illness, or those with disabilities.

Medicare Supplement Plans are Standardized 

You know that different insurance companies sell Medigap To ensure that each plan’s benefits remain uniform across all the insurance companies offering Medigap insurance, the supplements are standardized. It means that regardless of the insurance company selling the coverage, you will get the same essential benefits.

However, the cost of plans can be different depending on the insurance company offering the cover. But this does not mean that you will get more benefits since you paid more. Why then should you pay more when you can spend less? 

Your Medicare Insurance Plan Cannot Drop You If You Develop a Health Condition 

If you purchased the Medigap insurance plan after 1992, you don’t have to worry, and your coverage is guaranteed renewable. It means that the insurance company cannot drop you at will even after developing a severe health condition. There are only a few circumstances when they can drop you, such as failure to pay your premium, you lied during policy application, or if the insurance company becomes insolvent or is bankrupt.

However, if the company insuring your Medicare needs becomes bankrupt, you are guaranteed issue rights, enabling you to buy new plans.

The guaranteed issue right means that the insurance company is prohibited from using medical underwritings to charge you more for medical coverage or turn down your application.

However, if you bought your medicare policy before 1990, some of the insurance companies in some states can drop you. If it happens, you are eligible to acquire another Medigap policy, and all your past premiums will be taken into account.

Medigap Covers Your Health Needs When You Travel Abroad

Most health insurance covers only your health needs when you are in the United States. Therefore, what can you do if you become sick or injured while traveling abroad? No one knows when he will get sick anyway. It is for this reason that Medigap policy came to bridge the gap.

According to the policy plan, the insurance covers up to 80 percent of all your emergency healthcare needs during abroad travels. 

Medigap plan policies supplement insurance options for people who are already enrolled in a Medicare plan and those who need extra coverage of their health needs. Medigap policies bridge the gaps by paying various costs, such as deductibles, coinsurance, and co-payments.

However, the coverage is not 100 percent, and therefore you may have to pay some out-of-pocket expenses.


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