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MEDIGAP
Though traditional Medicare covers many healthcare costs, you might still face significant out-of-pocket expenses if you get sick. There are also many medical services that traditional Medicare does not cover. To help cover the “gaps” in traditional Medicare coverage, you might consider buying a supplemental insurance, or Medigap, policy. Medigap policies help cover the costs for hospital bills, nursing home bills, doctor bills, and other medical expenses that Medicare does not cover.


Evaluating Medigap Insurance

Choice of Doctors. You can see any primary care physician or specialist regardless of where they are located. Please note, these doctors must accept Medicare fee-for-service.

Monthly Premiums. Medigap policies generally charge you a premium on a monthly basis. Depending on which policy you choose and when you choose it, this monthly premium could range from $100 to several hundred dollars per month.

Availability of additional benefits. A couple of the more expensive Medigap policies offer limited prescription drug benefits that require policyholders to pay deductibles and coinsurance. Some also offer limited preventive care benefits while others offer to pay the $100 annual Medicare Part B deductible and 100% of the Medicare Part B excess charges.

Out-of-pocket costs. Medigap policies generally do a good job of filling the “gaps” in hospital bills, nursing home bills, and doctor bills that Medicare does not cover.

Out-of-area coverage. Some Medigap policies offer limited worldwide emergency care benefits that require you to pay deductibles and coinsurance.


Buying a Medigap Policy

The best time to buy a policy is during your Medigap open enrollment period. In general, your Medigap open enrollment period lasts six months from the date you begin receiving Medicare Part B benefits. During this six-month period, you have the right to buy the Medigap policy of your choice.

You cannot be turned down or charged higher premiums because of poor health if you buy a policy during this period. Once your Medigap open enrollment period ends, you may not be able to buy the policy of your choice. You may have to accept whatever Medigap policy an insurance company is willing to sell you.

There are ten standard Medigap policies that may be available to you. Enrollment rules vary by State. Each policy is assigned a letter (“A” through “J”). Plan A is the basic benefit package. Plan J provides the most coverage of all the plans. Although the benefits are identical for all Medigap plans of the same type, the premiums may differ greatly from one company to another and from area to area. To find out more about the Medigap plans in your area, click here http://www.medicare.gov/mgcompare/home.asp.

Once you find out which Medigap policies are available in your area, you can call any or all of the private insurers that offer these policies and request information from them. Since all of the policies have the same benefits, you will need to compare attributes like monthly premiums and the reputations of the companies offering the policies.

Before you can sign up for a Medigap policy, you must have Medicare Part A and Part B. Once you have taken this first step, you can contact your State Department of Insurance to find out which Medigap policies are available in your state or visit www.medicare.gov.

Here are the numbers in the tri-state area:
Connecticut: 1-800-203-3447
New Jersey: 1-609-292-5360
New York: 1-800-342-3736

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