While not all Medicare beneficiaries have the same healthcare needs and budgets, a Medigap plan may be a good solution for you. Our team at Magellan Healthcare can help you go over your options and determine which combination of coverage is the right fit for you.
Medicare Advantage vs. Medicare Supplement
People looking to save money on their Medicare health coverage are not usually satisfied with Original Medicare (Part A and Part B) alone. They turn to Medicare Advantage plans or Medicare Supplement policies.
Medicare Advantage plans are provided by private health insurance companies, and they cover the same Part A and Part B services as Original Medicare. Many Medicare Advantage plans use networks of healthcare providers, just like typical health insurance marketplace plans. These providers accept negotiated rates, which can help to lower your costs. Advantage plans can also offer benefits such as dental, vision, or hearing care, or prescription drug coverage.
Medicare Supplement (Medigap) policies work differently. They do not provide health coverage; instead, they help to reduce your out-of-pocket spending for Part A and Part B services.
You cannot purchase both a Medicare Advantage plan and a Medicare Supplement policy. Consider your healthcare and budgetary needs before choosing a combination of coverage that works best for you.
Benefits of Medicare Supplements
When you have a Medicare Supplement plan, it works with your Original Medicare coverage. Doctors who accept Medicare will accept the cost savings of your Medigap plan. Your Medigap also covers you across the country, not just within one geographic area.
Medigap policies can offer some of the following coverage areas:
- Part A coinsurance and hospital costs
- Part B copayments and coinsurance
- The first three pints of blood used in a procedure
- Part A hospice care
- Skilled nursing facility care
- Part A deductible
- Part B deductible
- Part B excess charges
- 80% foreign travel emergency care
Who Needs Medigap
Medigap is a good solution for people who frequently use their healthcare coverage or have high anticipated health costs. For example, look at the Part A deductible. Under Medicare Part A, deductibles are charged for each benefit period, which is the time between being admitted as an inpatient and when you have not received inpatient services for 60 days. You can quite possibly be expected to pay the Part A deductible multiple times over the course of a year, at $1,556 in 2022 per benefit period. Part A coverage also charges a daily coinsurance once you have been an inpatient for at least 60 days within the same benefit period. If you anticipate needing to pay for these costs, a Medigap plan that covers Part A out-of-pocket expenses can save you thousands of dollars.
Medigap plans cover individuals, so it is quite possible that one spouse may benefit from a policy while the other does well with a Medicare Advantage plan. Your coverage needs may change over time, so it is important to evaluate your costs and make decisions that will put your physical and financial health first.
