Medicare

Original Medicare, Parts A and B, pays for many of your health-care services and supplies, but it does not pay for everything. That’s why you may want to consider getting a Medicare Supplement insurance policy, also called a Medigap policy. A Medigap policy is sold by private insurance companies. These plans help pay some of the hospital and medical costs that Original Medicare does not cover, such as copayments, coinsurance, and yearly deductibles. Basically, a Medigap policy fills the “gaps” in Original Medicare coverage.

How Medicare Policies Work With Medicare

A Medigap policy supplements your Original Medicare benefits, which is why these policies are also called Medicare Supplement plans. If you have Original Medicare and a Medigap policy, Medicare will pay first, as your primary insurance, and your Medigap policy will fill in the cost gaps. For example, suppose you have a $5,000 ambulance bill and have not yet met the yearly Medicare Part B deductible. Medicare Part B will pay 80% of your ambulance bill, minus the deductible amount. The Medigap policy would then pay your remaining 20% coinsurance of your $5,000 ambulance bill. Some Medigap policies also pay the remainder of the Medicare Part B deductible you still owe.

INSURANCE PLANS THAT AREN'T MEDIGAP

  • Medicare Advantage Plans (like an HMO, PPO, or Private Fee-for-Service Plan)
  • Medicare Prescription Drug Plans (Part D)
  • Medicaid
  • Employer or union plans, including the Federal Employees Health Benefits Program (FEHBP)
  • TRICARE
  • Veterans' benefits
  • Long-term care insurance policies
  • Indian Health Service, Tribal, and Urban Indian Health plans