What is the Primary Difference Between Medigap and Medicare?
Original Medicare covers 80% of Medicare-covered services such as outpatient medical services, your doctor’s services, and supplies. However, Medigap covers some of the gaps that Original Medicare doesn’t pay for, such as deductibles, copayments, and coinsurance.
In this post, we will explore the benefits and advantages of Medicare and Medigap.
What is Medigap?
Private companies sell this supplemental insurance policy that you can use along with Medicare Parts and Parts B. However, that means it is an optional insurance policy, and if you decide to enroll in one, you will have to pay a monthly premium to a private insurance carrier. That’s an additional cost to the monthly Part B premium you pay to Medicare.
What does Medigap Cover?
Generally, Medigap plans cover out-of-pocket costs for services that Medicare covers instead of those that Medicare doesn’t. So, for instance, this plan won’t cover any vision or dental charges since Original Medicare doesn’t provide routine vision and dental coverage.
The open enrollment period starts from the first day of your 65th birthday and lasts six months, provided you are also signed up for Medicare Part B. However, there is no guarantee that you will get any coverage if you buy a Medigap policy outside this window.
This government-funded insurance option is available to all individuals who are 65 or above. People receiving disability benefits can also enroll in Medicare and choose various coverage options. You become eligible to sign up for Part A and Part B three months before your 65th birthday and end three months after this day.
Medicare Part A
Part A offers coverage for hospital services, including limited home healthcare visits, hospital services, inpatient hospital care, hospice care, and short-term skilled nursing facility stays.
Medicare Part B
It offers coverage for general medical services, including diagnostic, preventive, and treatment services. Part B also covers emergency medical transportation and emergency room visit costs.
Medicare Part C or Medicare Advantage
Private insurance companies offer Part C, which is more popular than Medicare Advantage. It covers Part A, Part B, other healthcare such as vision and dental care services, and prescription drugs.
Medicare Part D
It offers coverage for prescription drugs. In addition, private insurance companies provide Medicare Part D as an add-on to the original Medicare plan.
For most Americans, Original Medicare covers the most medical expenses. It comprises Medicare Part A and Medicare Part B. But remember that original Medicare won’t cover dental and vision services or prescription drugs.
Benefits of Original Medicare
Coverage all over the U.S.
Original Medicare is accepted all over the country. That’s highly beneficial for frequent travelers.
Many individuals don’t pay a monthly premium for Part A. Furthermore, the monthly premium for Medicare Part B begins from just above $148. Your monthly Medicare costs will automatically deduct from your Social Security payment if you receive any
If you have original Medicare, you can choose any provider that accepts Medicare. That means you don’t have to switch from your preferred healthcare provider after enrolling in this plan.
What is Medigap vs. Medicare Advantage?
Some people wonder if a Medigap policy and a Medicare Advantage (Part C) plan are the same.
The purpose of Medigap is only to fill the gap in your Original Medicare coverage. It is a supplemental type of plan.
Which One is Better?
Both Medigap and Medicare Advantage has some advantages and disadvantages.
Here are some benefits that come with Medicare Advantage:
- More benefits and coverage, including services like disability equipment, long-term care, gym memberships, etc.
- Lower premiums
- It covers Medicare Part A, B, and D
Here are some disadvantages of Medicare Advantage:
- Ensure that your preferred provider is in your plan
- No coverage while traveling
- Higher emergency and out-of-pocket costs
Now let’s look into some advantages of enrolling in Medigap
- It gives access to all providers who accept Medicare
- Coverage while traveling overseas
- Fewer out-of-pocket expenses
Some disadvantages of Medigap plans include:
- Higher monthly premiums
- No prescription coverage (which is available through Plan D)
- You will have to choose from different types of plans
Whether you decide to enroll in Medigap or Medicare, make sure you don’t miss out on the enrollment period.