Medicare Supplement Insurance (Medigap)

Pataasin ang iyong marka sa homework at exams ngayon gamit ang Quizwiz!

There are ______ standard Medigap Plans

10

A Medicare Supplement policy that contains restricted network provisions is known as

A Medicare SELECT policy (Medicare select certificate mean)

Medicare supplement (Medigap) policies do NOT pay for

Extended nursing home care

A Medicare supplement policy is designed to

Fill the gaps in original Medicare and Parts A and B

When a Medigap policy is replaced, the applicant must sign a

Notice to Applicant Regarding Replacement of Medicare Supplement Insurance

The Medicare supplement plan with the most amount of comprehensive coverage is

Plan J

Medicare Supplement policy applicants must be give an Outline of Coverage that describes the policy's

Principal coverage and benefits, premium, and renewal provisions.

Sold by

Private companies

The core policy (Plan A) developed by NAIC as a standard Medicare supplement policy includes all of the following EXCEPT

The Medicare Part A deductible

In the standardized Medicare supplement policy, Plan A is referred to as the core plan, but offers

The least amount of comprehensive coverage

All standard Medigap plans must include certain basic (core) benefits

• 100% of Part A hospital coinsurance plus the full cost of 365 additional days after all Part A hospital beds are exhausted • Part B coinsurance or copayment after the annual deductible is met—100% for all plans except K (50) and L (75)

When a Medigap policy is replaced, the applicant must be given

• A refund of unearned premium on the replaced policy • Credit under the new policy for any time elapsed under the pre-existing condition provision of the replacement policy

Required Provisions

• Medigap policies must be at least guaranteed renewable • Medigap policy benefits must be automatically adjusted for changes in Medicare • Medigap policies must have a 30-day free look period • Pre-existing conditions limitations may not last longer than 6 months from the date of issue.

The first page of a Medicare Supplement Policy must contain:

• The words "Notice to Buyer—this policy may not cover all of your medical expenses • Prominent notice of the 30-day free-look period • The policy's renewal provision including a description of any premium increases that may be involved.


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