Medicare Supplement Coverage

2014 Medicare and Medigap Updates

Before I write about Medicare supplement coverage, I feel I should provide a clear definition of Medicare. Simply stated, Medicare is a federal health insurance program. This program is applicable to people 65 years old and older. There are, however, some cases where people under 65 qualify for this government funded program, for instance, people with disabilities, people with end stage renal disease, or people who suffer from Lou Gehrig’s disease. Medicare supplement coverage is important, perhaps essential, because it is insurance that covers some of the out-of-pocket expenses not paid by Medicare.

If you fall under any of the above mentioned categories or situations and are consequently on Medicare, you can be assured that it will pay for a large portion of your health care. Sadly, however, it will not pay for all. To fill in this “gap”, you would need to purchase Medicare supplemental insurance or as it is sometimes referred to, Medigap insurance.

While Medicare is government provided insurance, Medigap or Medicare supplement coverage, is a policy sold by private insurance companies. These supplemental policies are designed to do what the name implies, fill in the gaps in original Medicare plans, or supplement the original Medicare policies. The combination of the two mentioned policies, Medicare and Medigap, should ensure the policy holder that they will not incur any out of pocket expenses.

Insurance companies are bound by law to only sell an individual a “standardized” Medicare supplemental coverage policy. There are, however, 12 different standardized Medigap policies offered for you to choose from (Medigap Plans A through L).For example, some plans offer benefits like emergency care while traveling outside of the country. For those people who travel extensively, this would be a policy to consider. Each policy carries with it specific benefit packages that are easily compared and each will vary in costs. Therefore, it is important that you choose wisely.

While Medicare supplement coverage is a great concept for filling in the gaps that Medicare does not cover, it is not without weakness. One of the major “problems” with Medicare supplemental insurance is that it will only pay what Medicare considers necessary, in other words, it will make payments based on what Medicare approves. The patient is, in effect, at the mercy of Medicare’s decision.

There are some individuals that do not need a Medicare supplemental policy. Individuals do not need a Medicare supplemental policy if they have group health insurance through an employer, either currently or a former employer; have Medicare Advantage plan coverage; or are enrolled in a Medicare Savings Programs like the Medicaid or the Qualified Medicare Beneficiary (QMB) Program.

The bottom line with Medicare is it does not cover all of your expenses. Unfortunately this is at the age where people typically have more health issues and are more dependent on health coverage. It is, therefore, important to maintain a Medicare supplemental coverage policy to avoid the financial pitfalls of healthcare and retirement; you should fill in “the gap”.

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