Medicare Supplement Plans, the Medigap Must know details

An insurance known as Medigap policy is the Medicare Supplement plans insurance. This is sold by private companies and it helps people in paying the costs of health care that is not covered by the Original Medicare such as deductibles, coinsurance and copayments.


Some Medicare Supplement plans in 2018 cover the services that the Original Medicare does not, such as medical care if you go traveling outside the U.S. Having Original Medicare and buying a Medigap policy indicates Medicare will pay for the Medicare-approved amount that covers the costs of health care. It is then that your Medigap policy pays.


A Medigap insurance policy is not the same as Medicare Advantage Plan.  Here are few things one must know regarding Medigap insurance policies.


  • It is a must to have Part A and B Medicare to have Medigap.
  • Having a Medicare Advantage Plan means you can get a Medigap policy, but ascertain before the starting of your Medigap policy you leave the Medicare Advantage Plan.
  • You pay monthly premium to the private insurance company for the Medigap policy besides the Part B premium to Medicare.
  • Medical Supplements Plan, the Medigap policy covers one person only and so a husband and a wife also must buy separate policies.
  • Medigap policy can be purchase from any insurance company in the state, ensure it is licensed.
  • The Medigap policy that is standardized is certainly renewable and until you pay the premium it is active.
  • Some policies of Medigap covered prescription drugs in the past, but the policies sold after 2006 are not permitted drug coverage. In case you want coverage for prescription drug, join Part D Medicare Prescription Plan for drugs.


Few valid points to know

  • Medicare Supplement Plans policies do not cover all.
  • The Medigap policies also do not cover dental or vision care, long term care, eyeglasses, hearing aids or private-duty nursing.


Insurance plans – not Medigap

  • Medicaid
  • Medicare Prescription drug plans
  • Medicare Advantage Plans such as PPO, HMO or Private fee- service plan
  • Tricare
  • Union or employer plans including the health benefits program of the Federal employees
  • Long term care
  • Veterans benefits


Dropping Medigap policy, know about it

If you wish to drop the Medigap policy entirely, timing is important. This is because you may expect a new Medigap policy that has drug coverage as well or wish to switch to Medicare Advantage Plan offering prescription drug cover. You will have to go in a row for 63 days or more before a new Medicare drug coverage starts.

An insight of Medicare Supplement Plans on Inpatient – Outpatient care

A Medicare Supplement that is known as ‘Medigap’ policy is sold by private companies and they assist in paying the health care costs such as deductibles, copayments and coinsurance that is not covered actually under the Original Medicare.


The original Medicare includes the coverage of Part A and B and this depends on the status of the hospital to consider a patient as inpatient or outpatients. These terms inpatient and outpatient matters because hospital insurance that is Medicare Part A covers inpatient care , while the medical insurance falls under Medicare Part B that covers the outpatient expenses. This means as an inpatient your hospital admission can affect coverage.  Thus, it is very important to know the Medicare coverage of inpatient and outpatient care.


Who is an inpatient?

Inpatient is when your doctor orders you for admission and formally admits you into a hospital room. This means you are under the doctor’s care and gives care instructions as you are in the hospital and so you are an inpatient until discharged. It may also be just an overnight stay at the hospital without the status of being inpatient.


Who is an outpatient?

If you go to a hospital for diagnostic tests or x-rays or visit emergency department or same-day surgery, you visit a hospital but are an outpatient as you spend the time to receive particular services. You are an inpatient only if you are admitted formally by the doctor orders.


Best Medicare Supplement Plans in 2019 qualify you at least when you are in a hospital as inpatient for three days. This includes the admission first day, but not the day you are discharged.


How Medicare pays for inpatient vs. outpatient care?

Getting formally admitted in a hospital as inpatient is covered by Medicare Part A and you pay deductible Part A and this is covered generally in the first 60 days of your admission in hospital. Part A typically pays for meals, semi-private room, medical supplies, nursing care and treatments, in addition to prescription drugs required to treat you in the hospital.  Part B Medicare covers the visits of the doctor in the hospital and it is subjected to deductible Part B and coinsurance 20% amounts.


While, if you are getting at the hospital outpatient care and are under observation, Part B covers allowable costs and pays coinsurance amount. Having Medicare Supplement plans helps to get coverage for both, inpatient and outpatient as it covers copayments, deductible amounts and coinsurance.


In fact, Medicare Supplement plans get your benefits of Medicare as required same as Part A and B Original Medicare , except for the Part A hospice care  that is still only covered by Part A.