Insurance medigap plan

insurance medigap plan is also known as Medicare supplement insurance. Do you need a insurance medigap plan? Is there a waiting period? Are there protections for consumers? Here are answers to these and other frequently asked questions.

Why do I need a insurance medigap plan?

Although Medicare covers many health care costs, you still have to pay Medicare's coinsurance and deductibles. There also are many medical services that Medicare does not cover. A insurance medigap plan provides reimbursement for the out-of-pocket costs that are not covered by Medicare and which are the beneficiary's share of health care costs. There are ten standard Medigap policies, and each offers a different combination of benefits.

What effect does a "pre-existing condition" have on purchasing a insurance medigap plan?

• If you purchase a insurance medigap plan at an older age, you may have a six-month period of non-coverage for a particular pre-existing condition, after which your coverage will be total. This period may be reduced if you had previous health insurance coverage for at least six months and you enroll in a insurance medigap plan within 63 calendar days.
• If you switch from one insurance medigap plan to another, you have full coverage for all health problems, if you had the previous policy for at least six months.

If you join a Medicare HMO, stop your insurance medigap plan and then disenroll from the HMO, you have 63 days to purchase a insurance medigap plan and NOT face a new six-month period of non-coverage for a pre-existing condition.

Insurance medigap plan paperwork?

A insurance medigap plan company is required to send you an Explanation of Benefits to prove that it paid its portion of your claims for your health benefits. Combined with the Explanation of Medicare Benefits which you may receive from Medicare, you will have the total information about how your health care claim was processed.

You do not need more than one insurance medigap plan. State law prohibits an insurance company or salesperson from selling you a second insurance medigap plan that duplicates the coverage of one you already have, unless you plan to discontinue your current policy.