Top Ten Things You Need to Know
Before Purchasing Medigap Insurance

1. Definition of Medigap Insurance: Medigap Insurance is a private health insurance policy commonly referred to as “Medicare Supplement Insurance.” It is designed to pay for the 8 gaps in physician and hospital coverage left by Medicare Parts A and B.
    
2. What Medicare Supplement Policies Cover: Medigap Policies cover medical procedures approved by Medicare at a Medicare Provider. Procedures not approved by Medicare are normally not covered by Medicare Supplement Insurance. Some policies offer limited benefits for expenses not covered by Medicare such as at home recovery.
    
3. Eligibility for Medicare Supplement Insurance: Anyone who is covered under both Medicare parts A and B are eligible for Medigap Coverage. Insurance Companies reserve the right to set further qualification criteria beyond Medicare Eligibility at their own discretion but can not exclude any person who is in an Open Enrollment or Guaranteed Issue situation. See Medigap Eligibility>>>
    
4. Available Medicare Supplement Plans: Most states only allow standardized Medicare Plans A-L. Any company offering coverage is required to offer the base plan (Plan A) and any other combination of plans B-L at their discretion. See Medigap Plans>>>
    
   
5. Plan Differences Between Companies: The coverage between companies for doctor and hospital visits is exactly the same for the same standardized policy. For instance, a Plan F with one insurance company will pay exactly the same as a plan F with any other company. Companies may choose which standardized Medicare Supplement Policies they wish to offer but all must at least offer Plan A.
    
6. Pre-Existing Conditions: Medicare Supplement Insurance Companies may put a pre-existing conditions clause that limits their liability on previous medical problems for up to 6 months after the issue date of the policy. Some companies will not exercise this option. All companies must waive this limitation for the time that you were covered under previous creditable coverage such as a private or employer sponsored health plan or another Medigap policy.
    
7. Pricing Differences: Medicare Supplement Insurance prices vary from company to company, from plan to plan and from area to area. There is no standardization of pricing for Medigap Insurance. Therefore, you could pay substantially more for the exact same coverage if you do not shop around for the best rate for your particular situation. Request a Personalized Price Analysis >>
    
8. Choice of Doctors and Hospitals: Medicare Supplement Insurance does not limit you on the doctors or hospitals that you may choose. There are no networks. You simply choose any provider that accepts Medicare and your Medicare Supplement will pay that provider as stated in your policy.
    
9. Claims: Medicare Supplement Insurance has a very easy and mostly automated claims process. For Medicare Part B claims each Medicare Supplement Insurance company is linked directly to Medicare. Medicare will send the insurance company a copy of the claim and how they paid (known as a Medicare Explanation of Benefits or MEOB) to your Medicare Supplement provider each time they pay a claim. This is the claim that the insurance companies use to determine how to pay your claim. Because the claims come directly from Medicare, there is rarely a need for you or your doctor to file a claim for outpatient services.
    
10. Bottom Line: Medicare Supplement Insurance is very important and can provide you the peace of mind of knowing that you will not be burdened by the gaps in health coverage left by Medicare Parts A and B. However, it is important to compare plans and rates to make sure that you find the policy that is best for you. As Medicare Supplement Coverage is standardized in most states and the coverage is the same from company to company, it is very important to shop around to find the best available price.