MEDIGAP PLANS

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How many standardized Medigap Plans are there?

10 A, B, C, D, F, G, K, L, M or N Standardized by the NAIC to help consumers understand and compare them and make informed buying decisions

MEDIGAP POLICY

A Medigap policy is an insurance policy that helps supplement Original Medicare and is sold by private companies. A Medigiap policy can help pay some of the remaining health care costs that Original Medicare doesn't pay for covered services and supplies, like copayments, coinsurance, and deductibles. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. These are "gaps" in Medicare coverag

GUARANTEED ISSUE RIGHTS

Guaranteed issue rights (also called "Medigap protections")—Rights you have in certain situations when insurance companies are required by law to sell or offer you a Medigap policy. In these situations, an insurance company can't deny you a Medigap policy, or place conditions on a Medigap policy, like exclusions for preexisting conditions, and can't charge you more for a Medigap policy because of a past or present health problem.

Why is it important to buy a Medigap policy when I'm first eligible?

If you apply for Medigap coverage after your Open Enrollment Period, there's no guarantee that an insurance company will sell you a Medigap policy if you don't meet the medical underwriting requirements, unless you're eligible for guaranteed issue rights (Medigap protections) because of one of the limited situations listed on pages 22-23.

MEDIGAP POLICIES

Insurance companies selling Medigap policies are required to make Plan A available. If they offer any other Medigap policy, they must also offer either Plan C or Plan F to individuals who are not new to Medicare and either Plan D or Plan G to individuals who are new to Medicare. Not all types of Medigap policies may be available in your state.

Medigap

Medicare Supplement Insurance is sold by private insurance companies to cover medical costs not covered by Parts A & B

PLANS D AND G

Plans D and G with coverage starting on or after June 1, 2010, have different benefits than Plans D or G bought before June 1, 2010.

What Medigap policies don't cover

What Medigap policies don't cover Generally, Medigap policies don't cover long-term care (like non-skilled care you get in a nursing home), vision or dental care, hearing aids, eyeglasses, or private‑duty nursing.

Types of coverage that are NOT Medigap policies

• Medicare Advantage Plans (also known as Part C), like an HMO or PPO • Medicare Prescription Drug Plans (Part D) • Medicaid • Employer or union plans, including the Federal Employees Health Benefits Program (FEHBP) • TRICARE • Veterans' benefits • Long-term care insurance policies • Indian Health Service, Tribal, and Urban Indian Health plans • Qualified Health Plans sold in the Health Insurance Marketplace


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