Medicare
What is Medicare?
Originating in the 1960s, Medicare is a government-provided fee-for-service insurance program intended primarily for seniors. The program encompasses several distinct parts, each of which is outlined below.
- Medicare Part A covers facility-based care such as hospital visits, emergency room services, hospice, and nursing home care.
- Medicare Part B covers traditional outpatient treatments and services, including vaccinations, lab tests, mental health services, outpatient operations, durable medical equipment, and most other medical services not performed in a hospital.
- Medicare Part C (Medicare Advantage) covers elements of Parts A, B, and sometimes D.
- Medicare Part D covers prescription drugs.
- Medigap comes through private insurance companies and aims to fill in the “gaps” left in the traditional Medicare coverage.
Know Your Choices
While standard Medicare offers coverage for a wide variety of services, you may find that a different plan through a separate insurance carrier better fits your needs. If you are interested in an alternative plan, we can help you find coverage through either Medigap or Medicare Advantage. Both of these plans offer additional support through third-party insurers, and they are required to provide equal or better coverage when compared to regular Medicare.
Contact Us Today
If you believe that Medigap or Medicare Advantage is right for you, contact us today to discuss your insurance options.
*Disclaimer: This page has not been reviewed or endorsed by Medicare.gov or any member of the Centers for Medicare & Medicaid Services (CMS).
When you become eligible for Medicare, you may consider a Medicare Advantage Plan (i.e., Medicare Part C). Medicare Advantage Plans are offered by a set of approved private insurance companies. Medicare Advantage Plans offer all the benefits of Part A (Medicare hospital insurance) and Part B (medical insurance), with added benefits for hearing, vision, dental coverage. In addition, most Medicare Advantage plans include prescription coverage (Medicare Part D).
Medicare Advantage and You
You may consider Medicare Advantage, as this type of coverage offers more than Original Medicare. Original Medicare covers Medicare Part A and Medicare Part B, but without prescription drug coverage. Since these plans are offered to the public by private insurance companies, the cost of coverage varies. You will be responsible for paying your premiums, deductibles, and copays, which vary from plan to plan. One benefit of Medicare Advantage is that the out-of-pocket costs are capped, and once you reach the cap, you will owe nothing more for that year.
Consider Your Options
If you have a medical professional you want to continue to see, check the yearly provider list for the Medicare Advantage plan before you enroll, or ask your doctor at your next appointment. The various insurance companies vary in the cost of premiums and the range of benefits, so reviewing the alternatives is a crucial step in choosing the right Medicare Advantage Plan.
How to Enroll in Medicare Advantage
You have the option to enroll in Medicare Advantage during the initial enrollment period, which is seven months spanning the three months before you turn 65 to the three months following your 65th birthday. You have the option to upgrade to a Medicare Advantage plan to replace Original Medicare during the Medicare Enrollment period, which runs from October 15th to December 7th. You can change your existing Medicare Advantage plan at the Medicare Advantage enrollment period from January 1st to March 31st.
*Disclaimer: This page has not been reviewed or endorsed by Medicare.gov or any member of the Centers for Medicare & Medicaid Services (CMS).
Once you are eligible for Medicare, you can enjoy the benefits of Medicare Part A. This insurance covers the cost of inpatient care in hospitals and skilled nursing facilities (not long-term care). There is usually no monthly cost for Medicare Part A, as you paid to gain this insurance during your working years. If you did not pay Medicare taxes during working years, you can purchase Part A coverage.
Medicare Part A – How Does it Work?
When they reach the end of their years of employment, most people are eligible for Medicare. Medicare Part A is a critical part of this government health insurance plan and covers the following:
- Inpatient care: If you are admitted to a hospital, Medicare Part A covers the cost for 90 days. You must meet your deductible before the benefits in coinsurance and copays can begin.
- Skilled nursing facility care: Under Medicare Part A, you are covered for the costs of room, board, and many other services provided at a skilled nursing facility. To qualify, under Medicare rules, you must have spent three days consecutively in a hospital with a health condition that requires skilled nursing care. In addition, the coverage is limited to 100 days per benefit period.
- Home health care: If you have a health condition that leaves you homebound, Medicare Part A covers the cost of in-home care for up to 100 days. To be eligible for these services, you must have spent at least three days in a hospital within 14 days needing in-home healthcare services.
- Hospice care: For terminally ill people, Medicare Part A covers the cost of hospice care but requires a medical professional to certify the need for this type of care.
Medicare Part A and Added Costs
Medicare Part A does not cover the entire cost of your care, and you will need to cover some of it out-of-pocket, such as the deductible (which varies, plan to plan), coinsurance, and copayments for all eligible Medicare services.
*Disclaimer: This page has not been reviewed or endorsed by Medicare.gov or any member of the Centers for Medicare & Medicaid Services (CMS).
Medicare Part B covers medically necessary services or supplies that your doctor needs to diagnose or treat a wide array of medical conditions. For example, doctor visits, outpatient medical services, and standard medical and preventative care that is not covered by Medicare Part A are covered by Part B. To maintain Medicare Part B, you must pay a monthly premium. Most medically necessary services are covered under Medicare Part B and many types of durable medical equipment.
Which Medical Services are Covered by Medicare Part B?
Part B covers many medical services, including health screenings, ambulance services, blood tests, bone density tests, cardiac treatments, lab services, implantable defibrillators, diabetes, other screenings, and a wide array of standard medical services.
Medicare Part B covers treatments your doctors deem medically necessary, including chemotherapy, dialysis, imaging tests, and transplants. However, Medicare Part B does not cover routine physical exams, prescription drug costs, dental care, vision care, hearing aids, or alternative medical services such as acupuncture.
Are You Eligible for Medicare Part B?
If you are 65 or older, disabled, or have end-stage renal disease, you are eligible for Medicare Part B. When you enroll in Medicare, you can enroll in Part B. If you do not enroll at that time, your premium will depend on your income. If you do not enroll when you first become eligible for Medicare, you may need to pay a late enrollment penalty. So it makes sense to purchase Medicare Part B when you first enroll in the program.
What Does Medicare Part B Cost?
Your price could be higher or lower based on the income reported on your tax return two years before your enrollment. You will also be responsible for your deductible, coinsurance (about 20 percent of the cost of medical services), and copays for some services, such as outpatient hospital visits. You may or may not be automatically enrolled in Medicare Part B. It is advised that you speak with a local insurance agent to help you navigate the entire Medicare process, as it can be challenging to understand your options without guidance.
*Disclaimer: This page has not been reviewed or endorsed by Medicare.gov or any member of the Centers for Medicare & Medicaid Services (CMS).
Medicare Part D is a prescription drug program. As many people do, you should ensure you enroll in a Medicare Part D program if you take prescription medications. These plans are designed to reduce the cost of prescription drugs. If you are eligible for Medicare Part A and B, enroll in Medicare Part D at the same time, or you will pay more if you choose to enroll in a program later.
Medicare Part D – The Formulary
Every company that offers Medicare Part D issues a “formulary” or a list of the prescription drugs the plan covers. The formulary will vary based on the plan type and the insurance carrier. To enroll in the right plan, you must review the formulary to determine which of the medications you take are covered.
How Much Does Medicare Part D Cost?
To put Medicare Part D in place, you will need to choose a plan that suits your budget, as you will pay a monthly premium. The premiums vary from plan to plan. You will also share the cost of the medications until you reach the limit for the plan’s out-of-pocket costs. In most plans, after you reach the policy limit, you must pay only 25 percent of the cost of medications until you reach the next level. Once you have passed the out-of-pocket costs at that level, your copay or coinsurance costs will reduce even further. You can opt to have your Part D premiums deducted from your Social Security benefits every month.
*Disclaimer: This page has not been reviewed or endorsed by Medicare.gov or any member of the Centers for Medicare & Medicaid Services (CMS).
Medigap insurance is designed to cover the gaps in Original Medicare. Medigap insurance is offered by private insurance companies and is available in a wide range of plans. They are all required to offer a set of basic benefits, but some Medigap policies are designed to offer more. Original Medicare pays for a sizable portion of the healthcare services you need, but you are responsible for paying some portion, including copays, deductibles, and coinsurance.
Medigap insurance can help pay the out-of-pocket costs, up to set policy limits. Some policies will cover a portion of the cost of treatment if you become ill while out of the country. Medigap insurance is officially called “Medicare Supplemental Insurance.”
Am I Eligible for a Medigap Plan?
To be eligible, you must have Medicare Part A and Medicare Part B and will need to pay a monthly premium for the Medigap insurance. These policies cover an individual, not a couple, so both spouses must have a policy. Suppose you currently have a Medicare Advantage Plan (Medicare Part C). In that case, you are not eligible for Medigap insurance unless you choose to change your plan to Original Medicare, which includes Medicare Part A and Part B.
Choosing the right Medicare insurance can be challenging. Every person has unique needs, and the plan you choose matters. For assistance in buying the right Medigap policy, you can speak with a local insurance agent who can explain your options, the cost, what each policy covers, whether you are eligible for Medigap insurance, or what changes could be made to become eligible.
*Disclaimer: This page has not been reviewed or endorsed by Medicare.gov or any member of the Centers for Medicare & Medicaid Services (CMS).
What is Medicare?
Originating in the 1960s, Medicare is a government-provided fee-for-service insurance program intended primarily for seniors. The program encompasses several distinct parts, each of which is outlined below.
- Medicare Part A covers facility-based care such as hospital visits, emergency room services, hospice, and nursing home care.
- Medicare Part B covers traditional outpatient treatments and services, including vaccinations, lab tests, mental health services, outpatient operations, durable medical equipment, and most other medical services not performed in a hospital.
- Medicare Part C (Medicare Advantage) covers elements of Parts A, B, and sometimes D.
- Medicare Part D covers prescription drugs.
- Medigap comes through private insurance companies and aims to fill in the “gaps” left in the traditional Medicare coverage.
Know Your Choices
While standard Medicare offers coverage for a wide variety of services, you may find that a different plan through a separate insurance carrier better fits your needs. If you are interested in an alternative plan, we can help you find coverage through either Medigap or Medicare Advantage. Both of these plans offer additional support through third-party insurers, and they are required to provide equal or better coverage when compared to regular Medicare.
Contact Us Today
If you believe that Medigap or Medicare Advantage is right for you, contact us today to discuss your insurance options.
*Disclaimer: This page has not been reviewed or endorsed by Medicare.gov or any member of the Centers for Medicare & Medicaid Services (CMS).
Medicare Advantage
Medicare Part A
Medicare Part B
Medicare Part D
Medigap
Medicare Advantage
When you become eligible for Medicare, you may consider a Medicare Advantage Plan (i.e., Medicare Part C). Medicare Advantage Plans are offered by a set of approved private insurance companies. Medicare Advantage Plans offer all the benefits of Part A (Medicare hospital insurance) and Part B (medical insurance), with added benefits for hearing, vision, dental coverage. In addition, most Medicare Advantage plans include prescription coverage (Medicare Part D).
Medicare Advantage and You
You may consider Medicare Advantage, as this type of coverage offers more than Original Medicare. Original Medicare covers Medicare Part A and Medicare Part B, but without prescription drug coverage. Since these plans are offered to the public by private insurance companies, the cost of coverage varies. You will be responsible for paying your premiums, deductibles, and copays, which vary from plan to plan. One benefit of Medicare Advantage is that the out-of-pocket costs are capped, and once you reach the cap, you will owe nothing more for that year.
Consider Your Options
If you have a medical professional you want to continue to see, check the yearly provider list for the Medicare Advantage plan before you enroll, or ask your doctor at your next appointment. The various insurance companies vary in the cost of premiums and the range of benefits, so reviewing the alternatives is a crucial step in choosing the right Medicare Advantage Plan.
How to Enroll in Medicare Advantage
You have the option to enroll in Medicare Advantage during the initial enrollment period, which is seven months spanning the three months before you turn 65 to the three months following your 65th birthday. You have the option to upgrade to a Medicare Advantage plan to replace Original Medicare during the Medicare Enrollment period, which runs from October 15th to December 7th. You can change your existing Medicare Advantage plan at the Medicare Advantage enrollment period from January 1st to March 31st.
*Disclaimer: This page has not been reviewed or endorsed by Medicare.gov or any member of the Centers for Medicare & Medicaid Services (CMS).
Medicare Part A
Once you are eligible for Medicare, you can enjoy the benefits of Medicare Part A. This insurance covers the cost of inpatient care in hospitals and skilled nursing facilities (not long-term care). There is usually no monthly cost for Medicare Part A, as you paid to gain this insurance during your working years. If you did not pay Medicare taxes during working years, you can purchase Part A coverage.
Medicare Part A – How Does it Work?
When they reach the end of their years of employment, most people are eligible for Medicare. Medicare Part A is a critical part of this government health insurance plan and covers the following:
- Inpatient care: If you are admitted to a hospital, Medicare Part A covers the cost for 90 days. You must meet your deductible before the benefits in coinsurance and copays can begin.
- Skilled nursing facility care: Under Medicare Part A, you are covered for the costs of room, board, and many other services provided at a skilled nursing facility. To qualify, under Medicare rules, you must have spent three days consecutively in a hospital with a health condition that requires skilled nursing care. In addition, the coverage is limited to 100 days per benefit period.
- Home health care: If you have a health condition that leaves you homebound, Medicare Part A covers the cost of in-home care for up to 100 days. To be eligible for these services, you must have spent at least three days in a hospital within 14 days needing in-home healthcare services.
- Hospice care: For terminally ill people, Medicare Part A covers the cost of hospice care but requires a medical professional to certify the need for this type of care.
Medicare Part A and Added Costs
Medicare Part A does not cover the entire cost of your care, and you will need to cover some of it out-of-pocket, such as the deductible (which varies, plan to plan), coinsurance, and copayments for all eligible Medicare services.
*Disclaimer: This page has not been reviewed or endorsed by Medicare.gov or any member of the Centers for Medicare & Medicaid Services (CMS).
Medicare Part B
Medicare Part B covers medically necessary services or supplies that your doctor needs to diagnose or treat a wide array of medical conditions. For example, doctor visits, outpatient medical services, and standard medical and preventative care that is not covered by Medicare Part A are covered by Part B. To maintain Medicare Part B, you must pay a monthly premium. Most medically necessary services are covered under Medicare Part B and many types of durable medical equipment.
Which Medical Services are Covered by Medicare Part B?
Part B covers many medical services, including health screenings, ambulance services, blood tests, bone density tests, cardiac treatments, lab services, implantable defibrillators, diabetes, other screenings, and a wide array of standard medical services.
Medicare Part B covers treatments your doctors deem medically necessary, including chemotherapy, dialysis, imaging tests, and transplants. However, Medicare Part B does not cover routine physical exams, prescription drug costs, dental care, vision care, hearing aids, or alternative medical services such as acupuncture.
Are You Eligible for Medicare Part B?
If you are 65 or older, disabled, or have end-stage renal disease, you are eligible for Medicare Part B. When you enroll in Medicare, you can enroll in Part B. If you do not enroll at that time, your premium will depend on your income. If you do not enroll when you first become eligible for Medicare, you may need to pay a late enrollment penalty. So it makes sense to purchase Medicare Part B when you first enroll in the program.
What Does Medicare Part B Cost?
Your price could be higher or lower based on the income reported on your tax return two years before your enrollment. You will also be responsible for your deductible, coinsurance (about 20 percent of the cost of medical services), and copays for some services, such as outpatient hospital visits. You may or may not be automatically enrolled in Medicare Part B. It is advised that you speak with a local insurance agent to help you navigate the entire Medicare process, as it can be challenging to understand your options without guidance.
*Disclaimer: This page has not been reviewed or endorsed by Medicare.gov or any member of the Centers for Medicare & Medicaid Services (CMS).
Medicare Part D
Medicare Part D is a prescription drug program. As many people do, you should ensure you enroll in a Medicare Part D program if you take prescription medications. These plans are designed to reduce the cost of prescription drugs. If you are eligible for Medicare Part A and B, enroll in Medicare Part D at the same time, or you will pay more if you choose to enroll in a program later.
Medicare Part D – The Formulary
Every company that offers Medicare Part D issues a “formulary” or a list of the prescription drugs the plan covers. The formulary will vary based on the plan type and the insurance carrier. To enroll in the right plan, you must review the formulary to determine which of the medications you take are covered.
How Much Does Medicare Part D Cost?
To put Medicare Part D in place, you will need to choose a plan that suits your budget, as you will pay a monthly premium. The premiums vary from plan to plan. You will also share the cost of the medications until you reach the limit for the plan’s out-of-pocket costs. In most plans, after you reach the policy limit, you must pay only 25 percent of the cost of medications until you reach the next level. Once you have passed the out-of-pocket costs at that level, your copay or coinsurance costs will reduce even further. You can opt to have your Part D premiums deducted from your Social Security benefits every month.
*Disclaimer: This page has not been reviewed or endorsed by Medicare.gov or any member of the Centers for Medicare & Medicaid Services (CMS).
Medigap
Medigap insurance is designed to cover the gaps in Original Medicare. Medigap insurance is offered by private insurance companies and is available in a wide range of plans. They are all required to offer a set of basic benefits, but some Medigap policies are designed to offer more. Original Medicare pays for a sizable portion of the healthcare services you need, but you are responsible for paying some portion, including copays, deductibles, and coinsurance.
Medigap insurance can help pay the out-of-pocket costs, up to set policy limits. Some policies will cover a portion of the cost of treatment if you become ill while out of the country. Medigap insurance is officially called “Medicare Supplemental Insurance.”
Am I Eligible for a Medigap Plan?
To be eligible, you must have Medicare Part A and Medicare Part B and will need to pay a monthly premium for the Medigap insurance. These policies cover an individual, not a couple, so both spouses must have a policy. Suppose you currently have a Medicare Advantage Plan (Medicare Part C). In that case, you are not eligible for Medigap insurance unless you choose to change your plan to Original Medicare, which includes Medicare Part A and Part B.
Choosing the right Medicare insurance can be challenging. Every person has unique needs, and the plan you choose matters. For assistance in buying the right Medigap policy, you can speak with a local insurance agent who can explain your options, the cost, what each policy covers, whether you are eligible for Medigap insurance, or what changes could be made to become eligible.
*Disclaimer: This page has not been reviewed or endorsed by Medicare.gov or any member of the Centers for Medicare & Medicaid Services (CMS).
When you become eligible for Medicare, you may consider a Medicare Advantage Plan (i.e., Medicare Part C). Medicare Advantage Plans are offered by a set of approved private insurance companies. Medicare Advantage Plans offer all the benefits of Part A (Medicare hospital insurance) and Part B (medical insurance), with added benefits for hearing, vision, dental coverage. In addition, most Medicare Advantage plans include prescription coverage (Medicare Part D).
Medicare Advantage and You
You may consider Medicare Advantage, as this type of coverage offers more than Original Medicare. Original Medicare covers Medicare Part A and Medicare Part B, but without prescription drug coverage. Since these plans are offered to the public by private insurance companies, the cost of coverage varies. You will be responsible for paying your premiums, deductibles, and copays, which vary from plan to plan. One benefit of Medicare Advantage is that the out-of-pocket costs are capped, and once you reach the cap, you will owe nothing more for that year.
Consider Your Options
If you have a medical professional you want to continue to see, check the yearly provider list for the Medicare Advantage plan before you enroll, or ask your doctor at your next appointment. The various insurance companies vary in the cost of premiums and the range of benefits, so reviewing the alternatives is a crucial step in choosing the right Medicare Advantage Plan.
How to Enroll in Medicare Advantage
You have the option to enroll in Medicare Advantage during the initial enrollment period, which is seven months spanning the three months before you turn 65 to the three months following your 65th birthday. You have the option to upgrade to a Medicare Advantage plan to replace Original Medicare during the Medicare Enrollment period, which runs from October 15th to December 7th. You can change your existing Medicare Advantage plan at the Medicare Advantage enrollment period from January 1st to March 31st.
*Disclaimer: This page has not been reviewed or endorsed by Medicare.gov or any member of the Centers for Medicare & Medicaid Services (CMS).
Once you are eligible for Medicare, you can enjoy the benefits of Medicare Part A. This insurance covers the cost of inpatient care in hospitals and skilled nursing facilities (not long-term care). There is usually no monthly cost for Medicare Part A, as you paid to gain this insurance during your working years. If you did not pay Medicare taxes during working years, you can purchase Part A coverage.
Medicare Part A – How Does it Work?
When they reach the end of their years of employment, most people are eligible for Medicare. Medicare Part A is a critical part of this government health insurance plan and covers the following:
- Inpatient care: If you are admitted to a hospital, Medicare Part A covers the cost for 90 days. You must meet your deductible before the benefits in coinsurance and copays can begin.
- Skilled nursing facility care: Under Medicare Part A, you are covered for the costs of room, board, and many other services provided at a skilled nursing facility. To qualify, under Medicare rules, you must have spent three days consecutively in a hospital with a health condition that requires skilled nursing care. In addition, the coverage is limited to 100 days per benefit period.
- Home health care: If you have a health condition that leaves you homebound, Medicare Part A covers the cost of in-home care for up to 100 days. To be eligible for these services, you must have spent at least three days in a hospital within 14 days needing in-home healthcare services.
- Hospice care: For terminally ill people, Medicare Part A covers the cost of hospice care but requires a medical professional to certify the need for this type of care.
Medicare Part A and Added Costs
Medicare Part A does not cover the entire cost of your care, and you will need to cover some of it out-of-pocket, such as the deductible (which varies, plan to plan), coinsurance, and copayments for all eligible Medicare services.
*Disclaimer: This page has not been reviewed or endorsed by Medicare.gov or any member of the Centers for Medicare & Medicaid Services (CMS).
Medicare Part B covers medically necessary services or supplies that your doctor needs to diagnose or treat a wide array of medical conditions. For example, doctor visits, outpatient medical services, and standard medical and preventative care that is not covered by Medicare Part A are covered by Part B. To maintain Medicare Part B, you must pay a monthly premium. Most medically necessary services are covered under Medicare Part B and many types of durable medical equipment.
Which Medical Services are Covered by Medicare Part B?
Part B covers many medical services, including health screenings, ambulance services, blood tests, bone density tests, cardiac treatments, lab services, implantable defibrillators, diabetes, other screenings, and a wide array of standard medical services.
Medicare Part B covers treatments your doctors deem medically necessary, including chemotherapy, dialysis, imaging tests, and transplants. However, Medicare Part B does not cover routine physical exams, prescription drug costs, dental care, vision care, hearing aids, or alternative medical services such as acupuncture.
Are You Eligible for Medicare Part B?
If you are 65 or older, disabled, or have end-stage renal disease, you are eligible for Medicare Part B. When you enroll in Medicare, you can enroll in Part B. If you do not enroll at that time, your premium will depend on your income. If you do not enroll when you first become eligible for Medicare, you may need to pay a late enrollment penalty. So it makes sense to purchase Medicare Part B when you first enroll in the program.
What Does Medicare Part B Cost?
Your price could be higher or lower based on the income reported on your tax return two years before your enrollment. You will also be responsible for your deductible, coinsurance (about 20 percent of the cost of medical services), and copays for some services, such as outpatient hospital visits. You may or may not be automatically enrolled in Medicare Part B. It is advised that you speak with a local insurance agent to help you navigate the entire Medicare process, as it can be challenging to understand your options without guidance.
*Disclaimer: This page has not been reviewed or endorsed by Medicare.gov or any member of the Centers for Medicare & Medicaid Services (CMS).
Medicare Part D is a prescription drug program. As many people do, you should ensure you enroll in a Medicare Part D program if you take prescription medications. These plans are designed to reduce the cost of prescription drugs. If you are eligible for Medicare Part A and B, enroll in Medicare Part D at the same time, or you will pay more if you choose to enroll in a program later.
Medicare Part D – The Formulary
Every company that offers Medicare Part D issues a “formulary” or a list of the prescription drugs the plan covers. The formulary will vary based on the plan type and the insurance carrier. To enroll in the right plan, you must review the formulary to determine which of the medications you take are covered.
How Much Does Medicare Part D Cost?
To put Medicare Part D in place, you will need to choose a plan that suits your budget, as you will pay a monthly premium. The premiums vary from plan to plan. You will also share the cost of the medications until you reach the limit for the plan’s out-of-pocket costs. In most plans, after you reach the policy limit, you must pay only 25 percent of the cost of medications until you reach the next level. Once you have passed the out-of-pocket costs at that level, your copay or coinsurance costs will reduce even further. You can opt to have your Part D premiums deducted from your Social Security benefits every month.
*Disclaimer: This page has not been reviewed or endorsed by Medicare.gov or any member of the Centers for Medicare & Medicaid Services (CMS).
Medigap insurance is designed to cover the gaps in Original Medicare. Medigap insurance is offered by private insurance companies and is available in a wide range of plans. They are all required to offer a set of basic benefits, but some Medigap policies are designed to offer more. Original Medicare pays for a sizable portion of the healthcare services you need, but you are responsible for paying some portion, including copays, deductibles, and coinsurance.
Medigap insurance can help pay the out-of-pocket costs, up to set policy limits. Some policies will cover a portion of the cost of treatment if you become ill while out of the country. Medigap insurance is officially called “Medicare Supplemental Insurance.”
Am I Eligible for a Medigap Plan?
To be eligible, you must have Medicare Part A and Medicare Part B and will need to pay a monthly premium for the Medigap insurance. These policies cover an individual, not a couple, so both spouses must have a policy. Suppose you currently have a Medicare Advantage Plan (Medicare Part C). In that case, you are not eligible for Medigap insurance unless you choose to change your plan to Original Medicare, which includes Medicare Part A and Part B.
Choosing the right Medicare insurance can be challenging. Every person has unique needs, and the plan you choose matters. For assistance in buying the right Medigap policy, you can speak with a local insurance agent who can explain your options, the cost, what each policy covers, whether you are eligible for Medigap insurance, or what changes could be made to become eligible.
*Disclaimer: This page has not been reviewed or endorsed by Medicare.gov or any member of the Centers for Medicare & Medicaid Services (CMS).