2014 Medicare and Medigap Updates
Medicare is the medical insurance provided by the U.S. Government for people over the age of 65. People below the age of 65 can also get Medicare coverage under certain circumstances. People under 65 get Medicare coverage if they are considered to have a certain predetermined disability or what is referred to as a qualifying medical condition such as end stage renal disease (ESRD) and are receiving disability payments from Social Security Disability Insurance (SSDI).
Even though Medicare is pretty comprehensive medical cover, it does leave some gaps that need to be filled. For this reason, there are a number of Medicare supplements. Medicare covers some hospital care such as in-patient hospital care, skilled nursing care after hospitalization and the first 3 pints of blood every year (Medicare Part A), medical coverage such as laboratory services, outpatient treatment, medical expenses (Medicare part B), and for prescription drugs (Medicare Part D).
However, Medicare does not pay for co-payments, co-insurance, deductibles and other out of pocket expenses that can be a significant financial burden. It also does not offer coverage for dental care, hearing aids, health costs incurred abroad, private nursing care, long term care and routine eye care. Medicare supplements can be purchased to cover some of these costs.
Medicare supplements are health insurance coverage policies that are provided by private insurance companies. The most well-known of all the Medicare supplements is Medigap which is also referred to as Medicare supplemental insurance.
Medigap is sold by private insurance companies licensed to do so by Medicare. These insurance companies are not bound by Medicare to sell insurance to people under the age of 65 and if they do sell any of the Medicare supplements, they are allowed to carry out medical screening on these persons. The insurance companies are not allowed to do medical screening on individuals who are 65 and over when first applying for Medicare as long as they do so within a six month period of when their coverage begins.
The Medicare supplements sold under Medigap are 10 standardized plans. The different plans offer different coverage and benefits. As a general rule, the more the benefits offered, the higher the insurance premium payable. The supplemental coverage may be used to pay for co-pays, con-insurance, deductibles and other health care expenses not covered by Medicare.
Even though the insurance companies offer standardized plans in terms of benefits, the premiums may vary significantly. For this reason, it is exceedingly important to compare the offerings from different insurance companies before deciding on one. It is also important to decide on what kind of extra coverage you need so as to decide on which of the 10 plans suits you best. This may help narrow your choices regarding the insurance company as not all will sell all the plans.
It may be a good idea to consult your insurance broker. He should be able to help you in making a decision. You can also get in touch with the local state department for information on the companies licensed to offer Medicare supplements.