Medigap health plans, like Medicare Plan F, are simply plans that help fill in the gaps where Medicare doesn’t provide coverage. The plans don’t have networks of physicians or hospitals, and they don’t make any determination about what is covered or not covered. They just take care of what are called “excess charges.” As we tell clients at our Yuba City Insurance Agency, it’s good coverage to have and virtually hassle free. However, there are some key considerations you need to be aware of.

What You Need to Know About Medigap

Other than in Massachusetts, Minnesota, and Wisconsin, Medigap plans come in 10 standardized packages. The plans differ in how much of your expenses they will cover. Of course, the more complete the coverage the higher its premium will we.

Here are some other factors to keep in mind as you consider your Medigap options. And, of course, talking with us at Ernstam is a great way to get up to speed quickly on the ins and outs of Medigap.

  • There are no ratings for Medigap plans like there are for Medicare Advantage plans. This is because Medigap benefits are the same no matter who you buy a plan from.
  • There are three ways of setting premium prices used by insurance companies. Community-rated plans charge everyone the same regardless of age. These are the least expensive plans over time, though they may not feel like it when you first buy one. Issue-age rated plans base your premium on your age when you buy the policy. It won’t go up as you get older but may due to the cost of inflation. Attained-age rate plans have premiums that start low but increase as you age. Over time, this kind of plan tends to be the most expensive.
  • The rules covering Medigap are not uniform across all locations. This is another great reason to talk with someone in your area who has expertise in Medigap coverage.
  • For six months starting the first day of the month you are at least 65 and enrolled in Part B, you have the right in every state to buy a Medigap policy and the insurance company is not allowed to use a pre-existing condition as a reason to turn you down or charge you more. This concept is called "guaranteed issue" but it only exists during that six-month grace period. After that, there are only certain triggering issues that guarantee you the right to get coverage without a pre-existing condition having an impact. These issues include having your Medicare Advantage plan shut down, you moving out of a plan’s service area, etc.
  • Medicare.gov has a complete listing of Medigap providers in your area. It lists the plans, price ranges, and contact information.

Get the Details on Medigap

Ultimately, it pays to talk with a Yuba City insurance agency like Ernstam about the specifics of Medigap and what you need in our situation. Contact us today at 530-751-1212 to learn more.

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