Is Medigap the Best Medicare Supplemental Insurance?
There are decisions that have to be made about your healthcare. Which can lead to the question, is Medigap the best Medicare Supplemental insurance? This article will help you determine if Medigap is a good choice.
Let’s take a look at the Medicare insurance options available.
- Original Medicare
- Medicare Advantage Plan
- Medigap (Medicare Supplement)
When you have original Medicare Part A and Part B, your Medicare approved costs are covered up to about 80 percent. You are responsible for the remaining 20 percent.
Original Medicare includes the following:
In 2015, the Part A hospital deductible increases to $1,260. If you are admitted into the hospital, you pay the Part A deductible per benefit period. The Part B annual deductible remains the same at $147. If you seek Part B Medicare services, you pay the deductible and the remaining co-pays, co-insurance not paid by Medicare.
Is Original Medicare Part A and Part B the best option for you? For the majority of people, the answer is probably ‘no’. Healthy seniors find Original Medicare to work well. However, other people have had different and quite expensive experiences.
A client asked me to speak with her friend who fell ill. Her medical bills were piling up. Prior to her diagnosis, doctor visits were less than $10. The low out of pocket costs gave her a false sense of security. Her illness requires specialist care, surgery and follow-up treatments. Sadly, she does not qualify for a Medigap plan.
Medicare Advantage Plans
Medicare Advantage combines the following into Part C:
- Part A (Hospital Insurance)
- Part B (Medical Insurance)
- and usually Part D (Drug Insurance)
Medicare Advantage comes in the form of an HMO or PPO. You are required to use the plan’s network of doctors and hospitals. If you go out of network, you will have higher out of pocket costs. When you have a Medicare Advantage plan you cannot use Original Medicare or buy a Medigap policy.
Many people enjoy the low premium associated with a Medicare Advantage plan. However, that low premium also means fewer benefits. Let’s face it, you’re not going to get something for nothing.
You may pay little now, but a Medicare Advantage plan can make you pay a lot later.
Medicare Advantage Cons:
- It can be difficult to find covered medical care if you travel out of your area.
- Receiving emergency or urgent care can also be difficult due to networks and rules.
- You must follow the rules established by the plan in order to be properly covered.
- The networks can change at any time and your continuity of care can be interrupted.
- Maximum Out of Pocket expenses reset at the beginning of each calendar year.
- Plans can be financially unstable leaving your medical coverage vulnerable.
Personally, I can speak about the financial unstableness of Medicare Advantage plans. My mother signed up for a Medicare Advantage plan when she retired. At the time, she didn’t want to spend money on a Medigap premium.
I gave her all the reasons she shouldn’t choose Medicare Advantage. But just like kids, parents have minds of their own too. She went ahead with her decision. A year later the Medicare Advantage plan went bankrupt.
What did this mean for my mom and thousands of other policyholders? It meant they were forced back to Original Medicare without any additional coverage for at least 30 days.
It didn’t take much to convince her to buy a Medigap plan. But she was still left vulnerable until her Medigap policy became effective. It was a very stressful time for her and many other seniors.
Needless to say, she was relieved to get out of the Medicare Advantage nightmare. Medigap is serving her well and she loves the freedom and peace of mind her plan provides. She now gets to visit her dermatologist who wasn’t available in the Medicare Advantage HMO network.
A Medigap plan is health insurance designed to fill the “gaps” of Medicare covered services not paid by Original Medicare. Medigap is also called Medicare Supplement insurance.
The Pros to having a Medigap Plan:
- Your choice of Medicare doctors anywhere in the USA!
- Your choice of Medicare hospitals anywhere in the USA!
- No networks
- No referrals needed. You have control over your healthcare!
- Comprehensive Medical Coverage
- Low to $0 out of pocket expenses
- Helps pay your share of co-insurance, co-pays, deductibles
- No dental, vision or hearing coverage outside of Medicare approved items
All Medigap plans have premiums. Each insurance company has their own set of rates. Most insurance carriers raise rates once a year. The great news is that CMS standardizes Medigap Plans. This means you get the same exact benefits regardless of which insurance company you buy from. The only difference is how much you pay.
“In this world, you get what you pay for.”
If you pay for comprehensive Medicare insurance, you’ll get comprehensive Medicare coverage. That doesn’t mean you have to buy the most expensive Medigap plan. There are plenty of choices and rates available.
So… is Medigap the best Medicare Supplemental insurance?
It’s a personal decision. But based on facts alone, the answer is ‘yes’. Original Medicare and Medicare Advantage limit your health care benefits and can leave you financially vulnerable. The right Medigap plan has very little financial risk.
REMEDIGAP concentrates on providing personal service from the very beginning. We don’t like hassling phone calls or high pressure tactics used on us, so we definitely don’t use them in our business.
We’re dedicated to helping you through the entire process at your speed. Each client has their own needs and we’ll customize our approach for you.
In the end, our goal is to always provide you with exceptional service and let you make your own decisions.
At REMEDIGAP, we don’t charge a fee. If you ever come across an insurance agent who does, you should look elsewhere. Insurance agents are compensated by the insurance carriers not by our clients.
Why wait? Contact us today through one of the many choices below.
- Call 888-411-1329
- Fill out our quote form
- Chat with us online
- Leave a comment below