Medicare Supplemental Health Insurance

2014 Medicare and Medigap Updates

Medicare Supplemental Health Insurance

Medicare is health insurance coverage provided by the federal government for 2 categories of people. The two categories are people over 65 years of age and people with a qualifying disability. This health coverage does cover a significant proportion of medical needs but it does leave some gaps. For this reason, a number of individuals opt to take on Medicare supplemental health insurance.

Medicare supplemental health insurance is also known as Medigap, for the simple reason that it exists to plug in the gaps left by Medicare. This health insurance is provided by private insurance companies that have been authorized by Medicare to sell these Medigap policies.

People over the age of 65 and who are already on Medicare automatically qualify for Medicare supplemental health insurance coverage. The private insurance companies are therefore bound by federal law to sell these Medigap policies to them. This is not the case for people receiving Medicare benefits due to disability. Insurance companies are not required to sell Medigap policies to them. However, if they do, they are allowed to carry out medical screening before doing so. As a general rule, people over 65 should not be subjected to medical screening before getting Medigap coverage.

Despite the fact that different insurance companies offer Medicare supplemental health insurance coverage, benefits under the different plans are exactly the same. This is because federal and state laws require the private insurance companies to sell standardized policies. The Medigap policies are identified by letters A through to N. However, Wisconsin, Minnesota and Massachusetts have different standardized plans.

As the plans are standardized, it can be a bit difficult to choose among the different insurance companies. Your choice may have to come down to cost. This is because even though there are strict rules regarding the Medigap plans, the companies are not restricted as to how much premiums they charge on the policies.

The 4 Medicare supplemental health insurance plans E, H, I and J are no longer offered by any insurance company. However, the companies are required to continue offering coverage to person who had enrolled under these plans before they got scrapped. The private insurance companies do not have to offer all the other plans but they do have to offer plan A. If they offer more than one Medigap plan (a company can offer only one plan), they have to offer either of plan C or F.

Even though Medicare supplemental health insurance plans are designed to fill the gaps left by Medicare, they still do not provide coverage for dental care, vision care, eyeglasses, hearing aids, long term care and private duty nursing. These plans also do not offer prescription drug coverage due to legislation changes in 2006.