Medigap: Should I consider buying it?

Submitted by Anonymous (not verified) on Fri, 02/27/2009 - 11:36

Hi Folks, can anyone enlighten me on the Medigap insurance? I've heard it offers more exhaustive coverage than the Medicare. Can anyone opt for the Medigap coverage instead of Medicare?

Posted: 28 Feb 2009 04:53 Post Subject:

Medigap


i hope all the queries are solved with this. :wink:


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Posted: 28 Feb 2009 10:00 Post Subject:

Hi Joe, Medigap, as the name suggests is designed to fill-in the gaps left by Medicare. It, however, can't replace Medicare.

Medicare would only pay around 50% of the total medical expense. The rest needs to be carried by the recipient. Medigap in such cases would compensate a portion of the out-of-pocket expense of the insured.

~Jeremy

Posted: 28 Feb 2009 10:29 Post Subject:

You should be careful while choosing the Medigap policies from the existing ones. Around twelve types of Medigap plans are available. Though standardized, every plan may slightly differ from the other. Hence, the policy holder is required to review the plans closely before buying. And, also should compare the cost of coverage with the benefits offered.

Posted: 28 Feb 2009 10:55 Post Subject:

Aren't the qualifying criteria for Medigap associated with the Medicare part-B program? I think one is required to sign up with the Medicare part-B coverage in order to become eligible for the Medigap. Isn't that right folk?

Posted: 28 Feb 2009 12:31 Post Subject:

Aren't the qualifying criteria for Medigap associated with the Medicare part-B program? I think one is required to sign up with the Medicare part-B coverage in order to become eligible for the Medigap.



yes you truly understood it. one need to be part of the medicare in order to avail the benefit of the medigap. :wink:

Posted: 28 Feb 2009 08:48 Post Subject: Medigap(Medicare Supplement) Insurance

Hi Old_Joe:

First off, just to let you know, I am a licensed insurance agent. Another point you should know is that I am licensed in approximately 30 states, so hopefully I can be of assistance to you.

First of all, Medicare is now made up of four parts, Part A, Part B, Part C and lastly Part D. I will try to make the explanation of these as brief as possible.

Part A - Principally covers the cost of a hospital stay, which also has a deductilbe of $1064 per benefit period for 2009. In addition to the deductible, you are responsible for an additional 20% of the hospital cost.

Part B - This part applies to the cost of the various doctors that you might need, whether it is in or out of the hospital. This has an annual deductible of $135 for 2009 plus you are responsible for 20% of the balance.

Part C - This is a new form of Medicare that Congress created in 1997. It resembles a traditional major medical insurance plan. Versus having a deductible, it contains a co-pay for a medical expense; i.e. a doctors office co-pay, etc. Also, a large portion of these plans are zero premium plans plus they offer additional benefits that are not available with traditional Medicare with a supplement.

Part D - This is the new cription drug coverage that is available to us seniors. When selecting a prescription drug plan, you first determine the plan or plans that cover all or nearly all of your prescriptions. Secondly, you then review their various drug co-pays, and then their monthly premium cost.

If you have any further questions, contact me by calling 800-770-6202 or via and Email at eugene.scott602[at]comcast.net

Posted: 02 Mar 2009 12:14 Post Subject:

Hi Old_joe

As far as I know, Medigap and Medicare work hand in hand. Where Medicare can't provide more benefits, Medigap comes in. Again Medigap also offers Medicaid, Prescription Drug Assistance, coverage for people with restricted income. So i guess, having either of the two won't be too beneficial. If you really want to enjoy the benefits, you can have both.

Posted: 02 Mar 2009 01:32 Post Subject:

Hi,

Medigap as the name suggests is designed to fill-in the gaps left by Medicare.



I guess if it's not possible for you to have both for some time, you should at least have Medicare in place. It should then be your primary objective to acquire Medigap as soon as possible. Remember, that it's you who have to think of a secured future in order to ensure safety for your loved ones.

ArindamSenIndies

Posted: 02 Mar 2009 04:02 Post Subject:

secured future in order to ensure safety for your loved ones.



beauty of the medicaid is if you are not qualified for it along with medicare but certainly your family members/children could be eligible for the medicaid.try it. :wink:

Posted: 14 Mar 2009 11:33 Post Subject:

Just because somebody has Medicare, it does not mean that they are exlcuded from having Medicaid coverage. Medicaid is run by the states, so it does vary some, but there are many different levels. Some people are eligible for drug assistance, some people are eligible for Medicaid to pay their Medicare Part B premium ($96.40), and then some people are fully covered by Medicaid.

HOWEVER, when one is a dual eligible (both Medicare and Medicaid)...Medicare is the primary and Medicaid pays most of the out of pocket costs. There are special needs plans out there (fall under Medicare Part C) that are actually designed to help dual eligibles receive more comprehensive care. For example, some cover Dental Care, Dentures, Vision, Glasses, Hearing Aids, OTC Drugs, Routine Transportation, and more.

The fact of the matter is, there are really two types of Medicare programs sold by agents. Medicare Supplements allow you to Pay in Advance (monthly premiums with virtually no out of pocket costs) and Medicare Part C programs or Medicare Advantage Plans that allow you to pay co-pays. Many people have strong opinions on which is better, but the truth is that it really depends on the individual.

The Medicare market is a product arena that is FILLED with agents looking to make a quick buck, and I do spend a great deal of time cleaning up after them.

Many people also do not realize that you could be 25 and on Medicare if you were disabled...so it's not just senior citizens that are subjected to these activities. If anybody needs more specific information, feel free to contact me!

Posted: 22 Mar 2009 03:29 Post Subject:

All i know is that Medigap is to supplement your Medicare insurance. It covers some areas that are not protected if you only own Medicare. You should at least own Medicare if you can't afford both at the same time. however, in the long run, it is more advisable to purchase Medigap as well, so you'll have a more all-rounded coverage.

Posted: 30 Mar 2009 05:13 Post Subject:

If we want to get really technical about it, there are NO Medi-Gap programs with no premium. You would be referring to MA's that have low or no premiums. MA's are not Medi-Gap policies because they pay instead of Medicare, not in conjunction with.

Posted: 01 Apr 2009 05:40 Post Subject:

Medigap is a nice option to best suit your need. You have options to cover for ambulance charges, skilled nursing, more hospital days even lifetime hospital charges coverage beyond medicare, foreign travel emmergency, at home recovery, preventive care coverage, special diseases such as cancer treatment, and many more.

Medigap Part A is always include core benefits. Other B through L medigap, you may have choice to choose in between. Mostly, Part is covered in other types. Your health condition and the rates affordable are the deciding factors. Also there are more regulations on these policies by the states, e.g. guaranteed issue wherein, you need not pass medical examination for proving your insurability. Although it is illegal to sell more than one medigap for insurance company, yet, some overlaps are allowed e.g. a cancer treatment.

Posted: 02 Apr 2009 01:36 Post Subject:

In the above message, when reading you should substitute the words like "Part A" to be Plan A. Medicare in itself has four "Parts". Parts A, B, C and D. Plans however go from A thru L. If you want to with a plan that will cover you well, go with plan F. It's very doubtful you will ever receive a doctor or hospital bill if you do. You pay the plan premium, you go to the doctor/hospital, the doctor/hospital bills medicare, medicare approves a certain amount, medicare transmits that info to the insurance company and they pay their 20% and medicare pays their 80%, you are left with 0%. Just that easy.
Medicare advantage plans (Part C), now that's a whole different ballgame...I say stay away from those...well, unless you like surprises!

Posted: 02 Apr 2009 07:01 Post Subject:

Hi Todd, don't you think that people should buy according to their needs? Since one product can’t satisfy the needs of all we see so many types of policies available in today’s market. plan F might cater to the needs of a certain segment of population but surely it wouldn’t cover all the requirements. Any specific reason to propose plan F?

Posted: 07 Apr 2009 01:16 Post Subject:

It bugs me that many agents will jump right to 'Oh you need plan F'. Yes, it has some of the highest coverages you can get on a Medigap plan, but not everyone NEEDS that much. Lord forbid they're low income and unable to afford the monthly dues.

It comes down to weighing cost vs. assumed risk - What are the odds that you'll need this? Are you willing to play these odds?

Then again, I tend to sell Part C plans more than I do Medigap, so I guess I'm slightly biased toward this subject :-p

Posted: 07 Apr 2009 03:13 Post Subject:

The main reason for the plan F is that the senior will not get bills. I have found that over the years, that's what seniors do, stay away from bills. They pay them all at the begging of the month because they need to see what they have left over. They pay the med supp...they are done! With a MA plan it's like Forest Gump and the box of chocolates...You just never know whatcha gonna get!
Now, when it becomes financially more sense to do the MA, you do it, but only then! Let me give you an true example. I have a client who is now 81. He is insulin dependent diabetic. No supps to be had because of it. I put him with a particular company and he has been there for years, but doesn't like the premium that it has steadily creeped up to. Right at $3000/year. So I gave him an MA plan at $0 premium with a $3000 out of pocket expense. He right now goes to the Dr. 2 times a year. Odds are in his favor he'll be better off now with that MA plan, then if the MA's gove south like we expect, I'll be able to put him on a guaranteed issue med supp again. Another example would be someone that's just shy of being on medicaid and can't afford a med supp or it would take a roof off her head, clothes off of her back, or food off her table, then yes give her the MA plan. (Or of course a "him")
I have sold plenty of both medicare supplements and MA's. I have sold thousands of supps, but only about 100 MA's, so I guess I'm slightly biased to doing the right thing by the client.

Posted: 07 Apr 2009 05:56 Post Subject:

I can see what you mean by doing right by the client, and I'm all for that in so many ways. But I see, and I'm not saying that your case is such, many agents simply pushing MedSup because the commissions pay more than MAs. It bothers me to no end when they refuse to look at the true needs of the client, and see what's going to best fit their needs for what they can afford - both on the front and back ends.

They both have their place, but I honestly think we'll be seeing more MedSup in coming years. More so with the MA subsidy changes that will be finalized tonight - can't wait to get the paper tomorrow and see how things are going to really be for 2010!

Anyway, I'm going to far off topic. To summarize, I get what you're saying. You're honest in your intent. However, I see to many agents out there that aren't, and only push MedSup for the higher payout.

Posted: 07 Apr 2009 06:30 Post Subject:

With Medigap you can have up to 12 different plans each with a different set of benefits. Although the benefits received from Medigap are same for all insurance companies, the costs can vary. So it is advisable that you compare plans. To get a Medigap policy, generally you must have Medicare Part A and Part B. In addition to the Medicare premium that you pay, you will also have to pay a premium for your Medicaid policy.

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