Medicare Supplemental Insurance

Medicare Supplemental insurance, or Medigap insurance is a type of health insurance specifically for senior citizens.  Medicare Supplemental insurance however, is not your average health insurance.  Actually, it is quite different than the well known ‘Medicare Insurance’.  You see, most senior citizens are automatically enrolled with Original Medicare Insurance upon reaching the age of 65.  Original Medicare insurance is basically a combination of Medicare Part A and Medicare Part B.  What is Medicare Part A insurance?  Well, Medicare Part A insurance is basic hospitalization insurance.  Basically, Medicare Part B will help cover: Inpatient stays in hospitals, inpatient care in skilled nursing facilities, hospice care services, home health care services, and inpatient care in Non medical health Care institutions.  Medicare Part B on the other hand, is your basic medical insurance.  Medicare Part B will help cover: doctor services, outpatient care, home health care services, and even some Representative services.  So, when Medicare Part A and Medicare Part B is combined, you get Original Medicare Insurance.  In order to be eligible for Original Medicare, you must be 65 years or older (after all, this is health insurance for senior citizens).  In some cases, you may still qualify for Original Medicare insurance if you are suffering from a disability or if you have End Stage Renal Disease, or ESRD (Note: If you have questions regarding eligibility requirements for Original Medicare Insurance, you should call 1-800-MEDICARE).

Although Original Medicare insurance is beneficial to have, there is a major downfall that you should be aware of.  This major downfall is the amount of coverage Original Medicare offers.  You see, with Original Medicare insurance you are not 100 percent covered.  Actually, in some cases you are only up to 80 percent covered.  Your next question might be, who pays the remaining 20 percent?  Well, you do.  That’s right, you will be responsible to pay whatever Medicare does not cover.  So, depending on the service you receive in the hospital or in a doctors office, you may be looking at a high hospital bill.  For example, as you may know, surgeries are not affordable.  The average hip replacement surgery (which is one of the most common surgeries needed in senior citizens) costs nearly 10,000 dollars.  20 percent of 10,000 dollars will still leave you having to pay quite a bit of money.  Unfortunately, many senior citizens are on a fixed income and are not able to pay these high medical bills.  Actually, more now that ever before, many senior citizens are not willing to risk having to pay high medical bills.  This is exactly why more seniors are beginning to consider enrolling with a Medicare Supplemental insurance plan.

You see, Medicare Supplemental insurance, or Medigap insurance, helps cover the gaps left behind by Original Medicare insurance.  The best part of Medicare Supplemental insurance is the amount of coverage it offers.  For instance, with different Medicare Supplemental Insurance Plans, you are able to be 100 percent covered!  All you need to do is pay a monthly premium (on top of the Medicare Part B premium that you are required to have).  There are 10 different Medicare Supplemental insurance plans to choose from, each labeled by a letter from the alphabet.  There are Medicare Supplement Plans: A, B, C, D, F, G, K, L, M, and N.  each of these plans offer a different amount of coverage.  Usually, the amount of coverage offered by a plan directly coordinates with how much the plan costs.  For example, Medicare Supplement Plan F offers the most amount of coverage and therefore costs the most amount of money (usually).  Because there are so many Medicare Supplemental Insurance Plans to choose from, it is important to shop around online.


Enrollment in Medicare Part A should be accomplished as soon as possible after you reach 65 years old. Those with existing coverage can afford to wait, but it is important to note that any lapse in coverage lasting for a minimum of 63 days will incur a penalty upon enrollment. This penalty grows over time. Once you are covered by Medicare Part A, you will be eligible for Medicare supplemental insurance. This includes Part D Medicare supplemental drug plans.

Avoiding the Medigap Penalty

Medicare Parts A and B together will cover nursing facility residence and physician services, hospice, inpatient and outpatient care, home health care, and durable medical equipment. Everyone eligible for Part A is given the option to purchase Part B, which will require a premium. When coverage begins, you will immediately become eligible for Part D coverage. These Medicare supplemental drug plans must be purchased through approved private insurance companies. Most importantly, this Medicare supplement must be purchased within 63 days to avoid an enrollment penalty.

What is the Deductible for Medicare Supplemental Drug Plans?

Since these are offered by private companies, the deductible will vary by provider. It is worthwhile to shop around for the best overall plan. A toll free hotline has been established at 1-800-MEDIGAP to make the job easier. Despite differences between plans, they are all capped each year. No Medigap drug plan deductible can be higher than $320 in 2012.

Are Co payments and Coinsurance Also Regulated?

Once the deductible has been met for any Medicare supplement, you will still have to pay in one of two ways for prescription medications. Co payments will require a set dollar amount for each prescription, and coinsurance will require you to pay a percentage of any drug’s cost. Private insurers are free to establish limits for each, but they must be based on the Medicare formulary, also known as the tiered list of covered drugs. It can take a lot of research to compare the differences in cost. It can be even more frustrating when you are taking multiple, high-cost drugs. For professional assistance with comparing Medicare supplemental drug plans, call 1-800-MEDIGAPand speak to a representative today.

Shop Around Online for Medicare Supplemental Insurance

As we mentioned previously, it’s important to shop around online if you are looking for Medicare Supplemental Insurance.  You see, Medicare Supplemental insurance plans are standardized.  What does this mean?  All Medicare Supplemental insurance plans, regardless of what private insurance company you purchase the plans from, are required to offer the same amount of benefits and coverage.  What is not required however, is the price.  Each private insurance company is able to put their own price on the Medicare Supplemental Plans they offer.  So, as you can see, if you are looking for the best price, shopping around online is essential.  If you need help shopping around or if you have any questions, you can call 1-800-MEDIGAP.