Medigap’what is it’

“SAVVY SENIOR” You ask the Senior question ~ We find the Savvy answer By Jim Miller Dear Savvy Senior Since my husband died two years ago I have been learning the business side of life and am looking for a little instruction. Can you please teach me about Medigap insurance’ I am almost 65 years old and a friend was telling me I need to think about getting enrolled in a Medigap policy. My response was Medi-what’ Also, I need some Medigap shopping tips and does Medigap allow me to keep seeing my same doctor’ MediConfused Dear MediConfused, Here’s a medi-savvy syllabus on the Medigap basics. I hope this helps! A Medigap policy (also known as Medicare Supplement Insurance) is a health insurance policy sold by private insurance companies to fill the ‘gaps’ (expenses not covered by Medicare) in Original Medicare Plan coverage. There are 10 standardized Medigap plans called ‘A’ through ‘J.’ Each plan A through J has a different set of standardized benefits. Plan A offers the least amount of benefits and Plan J offers the most benefits. Savvy Note: Massachusetts, Minnesota and Wisconsin residents have different types of Medigap plans. When you buy a Medigap policy, you pay a premium to the insurance company. As long as you pay your premium, a policy bought after 1990 is automatically renewed each year. This means that your coverage continues year after year as long as you pay your premium. Savvy Reminder: Medigap policies only work with the Original Medicare Plan. Can I keep seeing my same doctor if I buy a Medigap policy’ In most cases YES! If you are in the Original Medicare Plan and you have a Medigap policy, you can go to any doctor, hospital, or other health care provider who accepts Medicare. But, if you have the type of Medigap policy called Medicare SELECT, you must use specific hospitals and, in some cases, doctors (except in an emergency) to get your full insurance benefits. When to buy a Medigap policy’ The best time to buy a Medigap policy is during your Medigap open enrollment period, which last for six months and begins on the first day of the month in which you are: Age 65 and older, and Enrolled in Medicare Part B. During this period, an insurance company cannot deny you insurance coverage, place conditions on a policy (like making you wait for coverage to start); change the price of a policy because of past or present health problems. Savvy Note: Insurance companies that use waiting periods for pre-existing conditions must generally shorten the period if you had other health insurance before you bought the policy. Medigap Shopping: Only you can decide if a Medigap policy is the right kind of health insurance coverage for you. If you decide to buy a Medigap policy, shop carefully. Look for a policy that you can afford and that gives you the coverage you need most. As you shop, keep in mind that insurance companies may charge different amounts for the same Medigap policy. Other Medigap Considerations: Contact your state insurance department to find out which insurance companies in your state offer the plan you’ve chosen and compare the premiums they charge. Also, check the method of rating (pricing). Policies are rated three ways: Attained-age, Issue-age and Community-rated. You might want to look for community-rated and issue-age-rated policies. They may be the best buy because even though they may cost you more at age 65, they’ll cost you less as you get older. Check to see whether the Medigap insurer you choose has arranged for Medicare to file your Medigap claims automatically. Automatic claims filing can save you time and headaches. Savvy Resources: Medicare Help Line: They can answer your questions and provide up-to-date information about Medicare, Managed Care Plans and Private Fee-For-Service plans in your area. Call 1-800-633-4227 or see For a list of the insurance companies and their phone numbers that sell Medigap plans in your state.

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