MEDIGAP PLAN COVERAGE
When it comes to health insurance, you want to avail yourself of all potential financial help. There’s no reason to pay out-of-pocket for expenses that Medigap plans cover.
If you’re thinking about applying for Medicare supplement insurance, you’ll want to know what each plan covers and how they compare to one another. Let’s explore some of the intricacies of Medigap insurance.
WHAT ARE MEDIGAP PLANS?
Medigap plans are separate insurance policies that complement Original Medicare Parts A and B. They cover some of the expenses that Original Medicare does not, from deductibles to copayments and coinsurance.
When you have Medicare supplement insurance, you experience fewer out-of-pocket expenses related to healthcare services and products. These savings can result in a more lenient budget during your post-retirement years.
You have 10 Medigap plans from which to choose, each of which covers different out-of-pocket expenses. Some such as C, F, and G, offer extremely comprehensive coverage, but at a higher price point. Others cost less up front but cover fewer out-of-pocket costs.
Understanding what your Medigap insurance covers can help you take advantage of your insurance policy and ensure you choose the right one. Let’s look at some of the factors that influence coverage.
UNEXPECTED MEDICARE SUPPLEMENT COVERAGE
Medigap plans are standardized. In other words, Medigap Plan A offers the same coverage levels regardless of the insurance company you choose. However, your premium can vary from one insurance carrier to the next since each provider can set its own rates.
Another thing to consider is whether or not an insurance company offers extra benefits above and beyond what the Medigap plans cover. In particular, consider these six unexpected Medigap insurance benefits that might come with your plan.
1. HEALTH CLUB MEMBERSHIP
A PBS article recently revealed that some Medigap plan providers are offering free health club memberships to beneficiaries. If you belong to one of these plans, you can avail yourself of numerous services, from workout classes and equipment to nutrition counseling and more.
A health club membership might help you stay healthy during your post-retirement years. Recent research suggests that engaging in regular fitness activity can reduce health risks in older adults. Furthermore, a health club membership offers you a unique opportunity to socialize with other people in your community.
Original Medicare covers telemedicine — also called “telehealth” — to some degree, but your Medigap supplement insurance could reduce your costs even further. For instance, Medigap plans that cover your Part B deductible — Medigap Plans C and F — will enable you to avail yourself of telemedicine services for free (Plans C and F are not available to new Medicare entrants, joining Medicare after January 1, 2020.)
Telehealth involves communicating with a doctor, nurse, physician’s assistant, nurse practitioner, or other healthcare professional via telephone or a video chat service like Skype.
Seniors who live in rural areas might not have access to nearby healthcare facilities, and sometimes doctors get so backed up that patients must wait weeks for appointments. Telemedicine provides a more efficient way for medical professionals to diagnose and treat patients without meeting in person.
3. MENTAL HEALTH
Did you know that Original and Medigap plans cover mental health treatment? You can use your Original Medicare Part A insurance for inpatient stays in mental health facilities, while Original Medicare Part B insurance covers outpatient services, such as visits to psychiatrists, psychologists, therapists, and counselors.
If you have certain Medigap plans, such as Medigap Plan G, you won’t have to make copayments coinsurance when you visit a mental health professional. Original Medicare will pick up part of the cost of each visit or treatment, and your Medigap supplement insurance might pick up the rest.
4. DURABLE MEDICAL EQUIPMENT
Durable medical equipment, or DME, refers to healthcare equipment you might need over a long period of time. For instance, CPAP machines used to treat sleep apnea fall under DME. The same goes for toilet chairs, canes, blood pressure monitors, crutches, and in-home hospital beds.
Before you pay for DME outright, find out what Original Medicare and Medicare supplement insurance will pay. In many cases, you won’t have any out-of-pocket costs related to this type of equipment.
5. SKILLED NURSING
If you need a skilled nursing facility to help you recover from an illness or injury, many Medigap plans cover the coinsurance and copayment required for those stays. Skilled nursing facilities provide general help with tasks like eating, using the restroom, getting dressed, and traveling to doctors’ appointments.
The confusion often arises over the difference between skilled nursing and nursing homes. Medigap plans do not pay for nursing home care, which is a lower level of care than skilled nursing care but requires more attention to the patient in terms of custodial type care.
6. HEALTHCARE ABROAD
If you enjoy traveling the world — or if you’ve always wanted to travel abroad once you reach retirement age — you might want to select a Medigap plan that offers foreign care insurance. Under these Medigap plans, 80 percent of covered treatments and visits will be covered.
It’s uncomfortable to get sick or injured while you’re in a foreign country, and it helps to know you won’t be liable for huge expenses after you get well.
Many people don’t realize what Medigap plans cover. If you’re not aware of the scope of your benefits, you might unwittingly pay for something that your insurance would cover.
To compare Medigap plans and decide on the best one for you, search for quotes using the Medigap Quoter. You can get information about what plans and premiums are available in your area so you don’t miss the opportunity to apply for Medicare Supplemental insurance.