There are various Medigap plans that allow Medicare beneficiaries to enroll in the most comprehensive coverage. Choosing a Medigap plan on your own can be frightening. With over 8 different lettered plans to choose from (Plans A –N) with different benefits we can navigate you through their differences to assist you in choosing the right plan for your budget.
Basics of Medigaps
Most Medigap plans cover the 20% that Medicare Parts A and B do not cover. Medigap plans are standardized by the government and are required to cover the same benefits as another carrier's plan.
Medigap plans have no network. You can get services from any doctor or facility that accepts Medicare. There are no networks or prior authorization required for services. They do not cover Medicare Part D so those plans can be purchased separately as well as any extra benefits such as vision and dental coverage.
* Plans F and G also offer a high-deductible plan in some states. This option requires you pay all Medicare Covered costs (coinsurance, copayments and deductibles) up to the deductible amount of $2,340 in 2020 before the policy pays. Plans F and C are not available in 2020.
** Plans K and L have out-of-pocket limits. Once you hit these amounts and pay your Part B deductible of $198 for 2020 the plans pay 100% of covered services for the year. Plan K out-of-pocket is $5,880 and Plan L is $2,940.
*** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits if you are not admitted to the hospital.
Medigap Eligibility and Enrollment
The best time to purchase a Medidgap Policy is when you are first eligible for Medicare so no underwriting is required. This is called the Open Enrollment Period (OEP) in which you will have guaranteed issue status. It starts the month you are eligible for Medicare Part B and lasts 6 months.
If you are outside your Open Enrollment Period (OEP) and you do not have a qualifying event to obtain Guaranteed Issue you will need to go through the carrier's underwriting process. Each carrier will require different underwriting questions and will have their own procedures, meaning some have strict underwriting and some have more lenient underwriting…… call us to find out more.
If you already have had a Medigap plan for several years chances are you are paying pretty high monthly premiums. There is no harm in testing the waters of underwriting to find a lower monthly premium, as long as you do not cancel your current policy.
Outside this guarantee issue period you will be subject to underwriting to obtain a policy.