Medigap hoạt động như thế nào?

Medical Supplemental (Medigap) – Medigap hoạt động như thế nào?

Medigap is NOT

•Medigap is NOT a Medicare Advantage (Part C) plan or other Medicare health plan.

•Medigap is NOT original Medicare. Medigap supplements Original Medicare benefits only.

•In addition,

• A Medigap plan cannot be used with a Medicare Advantage health plan.

It is illegal to sell a Medigap plan to someone already in a Medicare Advantage health plan

How does Medigap work?

Original Medicare pays for much, but not all, of the cost for covered health care services and supplies.

Medicare Supplement Insurance (Medigap) policies sold by private companies can help pay some of the remaining health care costs for covered services and supplies, like copayments, coinsurance, and deductibles.

Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. Generally, Medigap doesn’t cover long-term care (like care in a nursing home), vision or dental services, hearing aids, eyeglasses, or private-duty nursing.

Medigap plans are standardized

Medigap must follow federal and state laws designed to protect you, and they must be clearly identified as “Medicare Supplement Insurance.” Insurance companies can sell you only a “standardized” plan, identified in most states as plans A – D, F, G, and K – N.

All plans offer the same basic benefits, but some offer additional benefits so you can choose which one meets your needs.

In Massachusetts, Minnesota, and Wisconsin, Medigap plans are standardized in a different way. If you live in one of these states and want more information, visit Medicare.gov/medigap-supplemental-insurance-plans.

You can also visit Medicare.gov/publications to view the booklet, “Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare.”

People new to Medicare on or after January 1, 2020, have the right to buy Plans D and G instead of Plans C and F.

Compare the benefits of each lettered plan to help you find one that meets your needs now and in the future. You might not be able to switch Medigap policies later.

 = Plan covers 100% = Plan doesn’t cover% = Amount the plan covers

All Medigap plans pay for some or all of the following costs:

•Part A coinsurance

•Coverage for 365 additional hospital days when Medicare coverage for hospitalization ends

•Part B coinsurance or copayment

•Blood (First 3 pints)

•Hospice care coinsurance or copayment

Further Information on Medigap (Medicare Supplement Insurance)

•Medigap policies are available in standardized benefit plans, identified by certain letters between A and N (however, different plans are offered in Massachusetts, Minnesota, and Wisconsin).

•Turning age 65 and signing up for Part B triggers a six-month Medigap open enrollment period when Medigap insurers must issue you a policy, regardless of any pre-existing conditions. This is called a guaranteed issue right.

•In certain limited instances, leaving a Medicare Advantage plan may trigger a guaranteed issue right. Some states have additional guaranteed issue periods for Medicare beneficiaries.