A Guide to Health Insurance for People With Medicare

Medigap Mandate

Medigap policies are subject to federal and state regulations to protect Medicare participants, and they are clearly identified as supplemental coverage plans. Policies are required to be standardized, with slight variations in some states, and they are identifiable by letters A to L. The benefits from insurance companies are the same, but the costs might differ from one company to the next.

Purchase Requirement

Applicants must have Medicare Part A as well as Part B to purchase supplemental insurance. Premiums are paid to the company issuing the policy; this is in addition to your Medicare Part B monthly payments. A supplemental plan covers one participant, so if you are married your spouse has to obtain separate coverage to benefit from the program. Renewal is guaranteed regardless of the participant's health conditions. In addition, the plan cannot be terminated if your payment is in good standing.

Enrollment

Purchase Medigap insurance during open-enrollment season. This period starts on the first day you enroll in Medicare Part B at age 65 or older, and it continues for six months. It is important to sign up for coverage during open enrollment so you can attain the guaranteed service that might not be readily available after this period. For example, the participating insurance carrier is prohibited from using medical underwriting guidelines, and it cannot refuse you coverage or implement a time period to start your benefit. It won't assess higher premiums because of health problems. However, there are some exemptions for pre-existing conditions. If you sign up later than the stipulated time, you will lose out on some of the benefits.

Buying Coverage

Determine the level of coverage appropriate for you and your family. This can be done by reviewing your present as well as future health care needs. This is important in the event you are not able to change your supplemental coverage later on. Investigate which companies sell supplemental insurance in your state, and compare insurance carriers to find the one that is best for you. If you are a Medicare participant you might want to consider purchasing Medigap coverage. Medigap is referred to as supplemental insurance, which is normally purchased through privately run insurance companies. This type of coverage might pay for some of the costs that are excluded from your Medicare coverage plan, such as co-insurance, co-payments and deductibles. After Medicare has paid its portion, the supplemental insurance is meant to cover the balance.