MEDIGAP AND RETIREE INSURANCE

If you have other coverage or health insurance and Medicare, then each type of the insurance acts like a payer. Your doctor or other healthcare provider can bill Medicare if the insurance company has not made the payments. In this case, to pay off the bill amount, Medicare usually makes a conditional payment.

Let’s explore the different types of insurance Medicare works with:

  • Medicare Supplement Insurance (Medigap): A Medicare Supplement Insurance (Medigap) policy is sold by a private company and offers benefits that are not covered by Original Medicare like deductibles, coinsurance and copayments.

 

Original Medicare does not cover for services like health care when you are outside the US, this is taken care of by some Medigap policies. If you have purchased a Medigap policy and already have Original Medicare, then the health care costs covered by Medicare will be paid first, followed by your Medigap policy paying its share.

 

Medicare Supplement Plans 2018 is different from a Medicare Advantage Plan. Medicare Advantage plans provides ways to get access to Medicare benefits, while Medicare supplement Insurance (Medigap) supplements your Medicare benefits. Medigap policies do not usually cover hearing aids, dental or vision care, long term care or private duty nursing.

 

It may occur that you might want to drop your Medigap policy to switch to a Medicare Advantage Plan that provides coverage for prescription drugs, but you need to be careful with the timing of dropping out your Medigap policy. This is because late enrollment penalty will need to be paid when you join a drug plan offered by Medicare that begins after 63 days or more of when the Medigap policy have been dropped out of.

 

  • Retiree Insurance: If you are a retiree and have both a retiree insurance as well as Medicare, normally your health care bills are first taken care of by Medicare, and your retiree insurance pays second.

 

Since your health care bills are first paid by Medicare after you retire, your retiree coverage is similar to the coverage provided under Medigap. Although retiree insurance isn’t the same as a Medigap policy, but like it, the retiree insurance provides benefits that are otherwise not covered by Medicare like deductibles and coinsurance. At times, extra benefits can be covered by retiree insurance like coverage for staying more days in the hospital.