What Does Medigap Insurance Cover

By Larry Price


Folks who are approaching retirement age may want to begin applying for Medicare and checking out gap coverage. It is a good idea to learn what a gap plan offers. The gap plans are purchased from a private company and is in addition to Medicare. These Medigap insurance plans pay for those costs that Medicare does not. These costs include medical care received outside the US, co pays, and deductibles.

What the gap coverage will not pay for is dental and vision care or eyeglasses and hearing aids. In addition, there is no coverage for long term care or private duty nurses. Also, for prescription drug coverage folks will have to acquire a separate policy under Part D to cover their medications. Individuals will pay a premium each month for gap coverage that is separate from the Medicare B coverage.

If you already have Medicare A and B, you will be eligible to apply for a gap policy. Hospital costs are covered by Medicare part A while part B covers doctor costs. If you have an Advantage plan you are not eligible to purchase a gap plan. You will also need to find out which of the gap plans are offered in the area where you reside. This information can be found online on the State Department of Insurance website.

The standard plans, A through N, offer diverse levels of coverage. It is a good idea to compare the plans side by side. This comparison will help you understand which policy will best meet your needs. New subscribers can no longer get plans E, H, I, or J.

Monthly premiums for gap plans vary from company to company. However, the standard plans offered are always the same regardless who is offering them. The plans offer the identical set of benefits across companies. Some states have different standards for their gap coverage.

Folks can only buy their gap coverage during the open enrollment period. This period of time covers the 6 months before the first day of the month you turn sixty five. You must already be signed up to receive Medicare part B or it must be within six months of the date you signed up for it to be eligible to purchase. In addition, you can buy gap plans for the same premium amount of a healthy person.

Once the window of opportunity for purchasing gap coverage comes to an end, there is no guarantee that folks can get the coverage. If you are able to purchase coverage, there is a risk you will pay a higher premium. Remember that you will be paying a premium for Medicare B and a separate premium for your gap coverage. The gap premium will be paid to a private company.

Premiums are dependent on the policy that you select, where you live, how old are you, and the insurance company you purchase from. Paying your premium on a standardized plan on time guarantees that you will be renewed. Even if you have a pre existing health problem, you will be guaranteed the policy will renew.




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