Medigap Program

Summarizing the Medigap Program

When you have the Original Medicare Plan coverage, you will find it does not provide 100% coverage. You will be required to pay deductibles, co-pays, and co-insurance. While Medicare pays for a lot of health care services, there are still many it does not cover. Medigap was designed to pay the costs that Medicare does not cover (Medicare Consumer Guide, 2011).

Medigap coverage only works in conjunction with the Original Medicare Plan. Typically, you must have Medicare Part A and Part B (Medicare Consumer Guide, 2011). The core benefits for the Medigap program are Part A daily coinsurance for days 61 to 90 of hospitalization, Part A daily coinsurance for each of Medicare’s 60 lifetime impatient hospital days, 100 percent of covered hospital charges for 365 additional days after all Medicare hospital benefits have been used, Part B coinsurance amount (usually 20 percent of approved charges) after the deductible, and first three pints of blood per calendar year. In my opinion the coverage needs of consumers are sufficiently met by this program. But, I do think lower rates could be offered to seniors. The plans are fair considering the benefits and limits offered by each plan; I just think plans should good but a lower rate for seniors because they live on a fixed income. Elderly people have told me it is not that difficult having two insurances unless one or the other does not receive the correct information that they need. The two are not as closely related as people think. Medicare pays its portion (80% in almost all instances) then the Medigap plan pays its portion (the other 20%). They do not have to communicate to get paid because it is pre-determined by the respective outlines of coverage. There are no real implications for the insured; they will receive a Summary of Benefits from both Medicare and the secondary company Medigap.

Reference

Medicare Consumer Guide. Retrieved February 20, 2011...