What is Medigap? Is it Different from Medicare Supplement?

Medigap and Medicare Supplement plans are the same. There is another sort of plan known as Medicare Advantage, that is different from Medigap.

If you’re nearing retirement, it’s time to switch your health insurance to Medicare Parts A and B and purchase an additional supplement plan. It gets confusing between Medicare, Medigap, Medicare Supplement… Coverage Coach is here to help! With this article, we’re going to look at Medigap / Medicare Supplement Plans.

Remember, they’re the same thing. Let’s get some clarity on Medicare programs.

What is Medicare, a Medicare Supplement / Medigap Plan?

Medicare

Original Medicare (Part A and Part B) provides basic healthcare coverage and hospital insurance.

  • It’s a federal benefit you earned by working and paying payroll taxes and SSDI payments over the years.
  • You must have worked forty “quarters” — about ten years — to earn this retirement benefit.
  • Medicare Part A is hospital insurance and costs nothing.
  • Medicare Part B is more like traditional health insurance for seniors, but you will pay a premium.

Between Parts A and B, Original Medicare pays roughly 80% of approved costs for doctors, most hospital visits, and standard medical procedures. It won’t cover prescription medication, routine dental care, or vision. You’ll need to pay out-of-pocket for these or purchase additional senior health insurance like a Medicare Supplement plan.

Medigap / Medicare Supplement Plans

A Medicare Supplement Plan (“Medigap”) fills in the coverage gaps left by Original Medicare.

  • It’s a senior medical insurance policy you’ll purchase from a private insurer.
  • Consider plan costs, plan doctors, lifestyle and future travel plans, and any additional benefits in making your Medicare coverage choices.
  • One of the most significant points of coverage is Part D, which covers most prescription medicines.

Budgeting for Medicare + Medicare Supplement Plans

It isn’t easy to budget for our healthcare costs as we age. There’s no way to predict what sort of healthcare needs you might experience one year, five years, or ten years from today. Your costs could be huge or minimal. There’s no way to guess.

  • Original Medicare provides good basic coverage. But again, it pays about 80% of the costs it approves. Not everything gets approved. And sometimes, you’ll need to wait for approval before you can move forward with a procedure.

Then, there is the other 20% of the medical bill left over. That’s your responsibility to pay. And unlike coverage under the Affordable Care Act, which you might be accustomed to, there is no cap on the amount a person might have to pay in one year. If you need a serious surgery, like a heart bypass surgery after a heart attack, know that you’ll be on the hook to pay for 20% of it, unless you have a Medigap / Medicare Supplement or Medicare Advantage plan.

Medicare Supplement plans are well worth the price.

  • Seniors can rest easy knowing this supplemental insurance will cover most major medical costs.
  • Even if you live to be 100 years old without a major operation, the savings on prescription costs alone make Medigap a worthy investment.

We hope we’ve addressed your question about Medigap / Medicare Supplements. They are the same thing! As always, if you have questions, we didn’t answer, reach out to Coverage Coach for a no-pressure consultation. We’d love to hear from you.

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